The Effect of Periodontal Therapy on Preterm Low Birth Weight

Fogacci, Mariana Fampa; Vettore, Mário Vianna; Leão, Anna Thereza Thomé

doi:10.1097/aog.0b013e3181fdebc0

Cited by 61 publications

(62 citation statements)

References 38 publications

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“…The challenges are inversely related to gestational age at birth and the most severe adaptation problems occur during the first few weeks after birth. If preterm infants survive the difficult neonatal period, their body functions often adapt well, although some organ systems may show long-term developmental delay or deficits (18). It remains unknown how different organ systems adapt in preterm infants and when parameters of structure and function become similar to those in term infants.…”

mentioning

confidence: 99%

Rapid gut growth but persistent delay in digestive function in the postnatal period of preterm pigs

Hansen

Thymann

Andersen

et al. 2016

American Journal of Physiology-Gastrointestinal and Liver Physi

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Preterm infants often tolerate full enteral nutrition a few weeks after birth but it is not known how this is related to gut maturation. Using pigs as models, we hypothesized that intestinal structure and digestive function are similar in preterm and term individuals at 3-4 wk after birth and that early enteral nutrition promotes maturation. Preterm or term cesareandelivered pigs were fed total parenteral nutrition, or partial enteral nutrition [Enteral (Ent), 16 -64 ml·kg Ϫ1 ·day Ϫ1 of bovine colostrum] for 5 days, followed by full enteral milk feeding until day 26. The intestine was collected for histological and biochemical analyses at days 0, 5, and 26 (n ϭ 8 -12 in each of 10 treatment groups). Intestinal weight (relative to body weight) was reduced in preterm pigs at 0 -5 days but ENT feeding stimulated the mucosal volume and peptidase activities. Relative to term pigs, mucosal volume remained reduced in preterm pigs until 26 days although plasma glucagon-like peptide 2 (GLP-2) and glucose-dependent insulin-trophic peptide (GIP) levels were increased. Preterm pigs also showed reduced hexose absorptive capacity and brush-border enzyme (sucrase, maltase) activities at 26 days, relative to term pigs. Intestinal structure shows a remarkable growth adaptation in the first week after preterm birth, especially with enteral nutrition, whereas some digestive functions remain immature until at least 3-4 wk. It is important to identify feeding regimens that stimulate intestinal maturation in the postnatal period of preterm infants because some intestinal functions may show long-term developmental delay. prematurity; gut development; enzymes; digestion; glucagon-like peptide 2 ABOUT 10% OF ALL INFANTS are born preterm (Ͻ37 weeks of gestation) and the proportion is increasing in most countries (6). Preterm infants show an increased susceptibility to infections, respiratory distress syndrome, intracranial hemorrhage, bronchopulmonary dysplasia, retinopathy of prematurity, extrauterine growth restriction, neurodevelopmental disturbances, and necrotizing enterocolitis (NEC) (21, 31). The challenges are inversely related to gestational age at birth and the most severe adaptation problems occur during the first few weeks after birth. If preterm infants survive the difficult neonatal period, their body functions often adapt well, although some organ systems may show long-term developmental delay or deficits (18). It remains unknown how different organ systems adapt in preterm infants and when parameters of structure and function become similar to those in term infants. For gastrointestinal (GI) functions, eating disorders and dysregulated appetite have been reported in preterm infants (44) but very little is known about the long-term adaptation of the GI tract in preterm neonates.Investigations of postnatal GI adaptation in preterm neonates are difficult without an animal model that combines preterm birth, high NEC risk, and clinically relevant feeding interventions, such as parenteral and enteral nutrition. Piglets delivere...

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mentioning

confidence: 99%

Rapid gut growth but persistent delay in digestive function in the postnatal period of preterm pigs

Hansen

Thymann

Andersen

et al. 2016

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…There are also results from studies suggesting that periodontal care patterns or treatment of the disease during pregnancy is not associated with changes in the risk for LBW delivery (Hujoel et al, 2006;Michalowicz et al, 2006;Oliveira et al, 2011). Recent supporting meta-analyses further illustrate that treatment with scaling and root planing in this period is not protective statistically (Fogacci et al, 2011;Polyzos et al, 2010).…”

Section: Introductionmentioning

confidence: 93%

Influence of Socioeconomic Status on the Association between Prenatal Periodontal Care and Preterm Low Birthweight Delivery: A Population-Based Case-Control Study

Hsieh¹,

Yang²,

Liou³

et al. 2014

DENT

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We report the effect of in-pregnancy periodontal care intensity on the risk of preterm low birthweight (PLBW) births, and the role of household income in this association. Only a few studies have examined the role of socioeconomic status (SES) in the relationship between prenatal periodontal care and risk of PLBW delivery under universal health care. This study adopted a population-based, case-control study using medical claims data in Taiwan. Mothers of PLBW and non-PLBW babies with livebirth deliveries between 2001 and 2005 (cases, n=20430 and controls, n=81573, respectively) were identified using the National Health Insurance Research Database (NHIRD) and matched. Periodontal disease and disease-specific (gingivitis and periodontitis) dental service utilization was calculated during gestational period and analyzed for its association with risk for PLBW delivery. Household income as proxy for SES was tested for modification effect. Prevalence of periodontitis and gingivitis was significantly higher in cases than in controls. Women who had these inflammatory conditions and sought treatment for either condition more frequently in gestation were at significantly lower risk for PLBW deliveries (periodontitis AOR: 0.757, 95% CI: 0.689-0.832; gingivitis AOR: 0.684, 95% CI: 0.582-0.805). Moreover, household income did not appear to be a significant effect modifier in the association between in-pregnancy periodontal/gingival care and PLBW delivery amongst study subjects. We found evidence that the intensity of disease-specific dental care during pregnancy acts as independent risk factor for PLBW delivery for periodontal and gingival women, and that the modification effect by SES was not evident under the context of universal health care system.

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“…After examining eleven trials that included 6,558 patients, they found that periodontal treatment during pregnancy had no significant effect on the overall rate of preterm birth (OR = 1.15, 95%CI: 0.95-1.40; p = 0.15). In 2011, two meta-analyses were published by Chambrone et al 31 and Fogacci et al 32 , including 11 and 10 trials, respectively, neither of which supported the hypothesis that periodontal therapy reduces preterm birth and low birth weight indices.…”

Section: Comparisons With Other Studiesmentioning

confidence: 99%

Periodontal disease treatment and risk of preterm birth: a systematic review and meta-analysis

et al. 2012

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The events leading to preterm birth are still not completely understood. A quantitative systematic review was performed to estimate the effects of periodontal care during pregnancy on preventing preterm birth and low birth weight. The meta-analysis included randomized trials with pregnant women with a diagnosis of periodontal disease before 20 weeks of gestation. Relative risk (RR) with 95% confidence intervals (95%CI) was calculated. We evaluated the reduction in preterm and low birth weight. Thirteen trials were included, comparing 3,576 women in intervention groups with 3,412 women receiving usual care. The meta-analysis of the effects of periodontal disease treatment during pregnancy indicated a non-significant reduction in preterm births (RR = 0.90; 95%CI: 0.68-1.19) and low birth weights (RR = 0.92; 95%CI: 0.71-1.20). The creation and examination of a funnel plot revealed clear evidence of publication bias. In summary, primary periodontal care during pregnancy cannot be considered an efficient way of reducing the incidence of preterm birth.

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The Effect of Periodontal Therapy on Preterm Low Birth Weight

Abstract: Results of this meta-analysis do not support the hypothesis that periodontal therapy reduces preterm birth and LBW indices.

Cited by 61 publications

References 38 publications

Rapid gut growth but persistent delay in digestive function in the postnatal period of preterm pigs

Rapid gut growth but persistent delay in digestive function in the postnatal period of preterm pigs

Influence of Socioeconomic Status on the Association between Prenatal Periodontal Care and Preterm Low Birthweight Delivery: A Population-Based Case-Control Study

Periodontal disease treatment and risk of preterm birth: a systematic review and meta-analysis

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