Periodontal disease and perinatal outcomes: a case-control study.

AIM Our aim was to measure the association of maternal periodontitis with low birth weight (LBW), pre-term LBW, and intra-uterine growth restriction. MATERIAL AND METHODS An inclusive case-control design including subjects examined for periodontitis through attachment loss, information on perinatal outcomes and general health. Data were analysed through conditional logistic regression. RESULTS Cases (n=304) and controls (n=611) had similar prevalence and severity of periodontitis, defined as at least three sites, in different teeth, with loss of three or more millimetres of clinical attachment level. Several factors were associated with the outcome, but the crude odds ratio for periodontitis was not significant. Odds ratio were 0.93 [95% confidence interval (CI): 0.63-1.41] for LBW and 0.92 (95% CI:0.54-1.57) for pre-term LBW in the presence of periodontitis, after adjustment for maternal age, previous pregnancies, pre-natal care, smoking, previous low birth or premature birth and other medical conditions, on a hierarchical model. CONCLUSIONS Results do not support the hypothesis of association observed in previous studies after appropriate controlling for confounding variables. Negative peri-natal outcomes are better explained by determinants other than periodontal health. This study adds to the growing body of literature on the relationship between periodontal diseases and systemic health.

[1]  T. Köse,et al.  Periodontal infections and pre-term low birth weight: a case-control study. , 2005, Journal of clinical periodontology.

[2]  S. Huttly,et al.  The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. , 1997, International journal of epidemiology.

[3]  M C McCormick,et al.  The contribution of low birth weight to infant mortality and childhood morbidity. , 1985, The New England journal of medicine.

[4]  J M Bland,et al.  Statistical methods for assessing agreement between two methods of clinical measurement , 1986 .

[5]  M. Peres,et al.  Is there an association between periodontal disease, prematurity and low birth weight? A population-based study. , 2005, Journal of clinical periodontology.

[6]  G. Moreu,et al.  Relationship between maternal periodontal disease and low-birth-weight pre-term infants. , 2005, Journal of clinical periodontology.

[7]  Rui Vicente Oppermann,et al.  Validity of the "Community Periodontal Index of Treatment Needs" (CPITN) for population periodontitis screening. , 2006, Cadernos de saude publica.

[8]  H. Murthy Maternal risk factors associated with low birth weight , 1987 .

[9]  M. Mckee,et al.  The increase in very-low-birthweight infants in Germany: artefact or reality? , 2002, Paediatric and perinatal epidemiology.

[10]  J. Beck,et al.  Periodontal infection as a possible risk factor for preterm low birth weight. , 1996, Journal of periodontology.

[11]  H. Ohmi,et al.  Recent trend of increase in proportion of low birthweight infants in Japan. , 2001, International journal of epidemiology.

[12]  P. Papapanou,et al.  Periodontal infections and pre-term birth: early findings from a cohort of young minority women in New York. , 2001, European journal of oral sciences.

[13]  J. Hauth,et al.  Periodontal disease and preterm birth: results of a pilot intervention study. , 2003, Journal of periodontology.

[14]  B. Kirkwood,et al.  Case-control designs in the study of common diseases: updates on the demise of the rare disease assumption and the choice of sampling scheme for controls. , 1990, International journal of epidemiology.

[15]  A. Merchant,et al.  The association between maternal periodontitis and adverse pregnancy outcomes among poor Chilean women. , 2002, Journal of dental research.

[16]  A. Bauman,et al.  MATERNAL AND NEONATAL FACTORS INFLUENCING PREMATURE BIRTH AND LOW BIRTH WEIGHT IN AUSTRALIA , 2003, Journal of Biosocial Science.

[17]  Ana Maria Bellani Migott,et al.  Uso não-médico de medicamentos psicoativos entre escolares do ensino fundamental e médio no Sul do Brasil , 2006 .

[18]  B. Horta,et al.  Low birthweight, preterm births and intrauterine growth retardation in relation to maternal smoking. , 1997, Paediatric and perinatal epidemiology.

[19]  D G Altman,et al.  Comparing two methods of clinical measurement: a personal history. , 1995, International journal of epidemiology.

[20]  A. Beckett,et al.  AKUFO AND IBARAPA. , 1965, Lancet.

[21]  M. C. N. Costa,et al.  [Maternal periodontal disease as a factor associated with low birth weight]. , 2005, Revista de saude publica.

[22]  H. Morgenstern,et al.  Confounding in health research. , 2001, Annual review of public health.

[23]  M. Curtis,et al.  Maternal Periodontal Disease and Preterm Low Birthweight: Case-Control Study , 2002, Journal of dental research.

[24]  Patricio C. Smith,et al.  Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomized controlled trial. , 2002, Journal of periodontology.

[25]  Simone Seixas da Cruz,et al.  Doença periodontal materna como fator associado ao baixo peso ao nascer , 2005 .

[26]  A. Dasanayake Poor periodontal health of the pregnant woman as a risk factor for low birth weight. , 1998, Annals of periodontology.

[27]  S. Huttly,et al.  Caffeine intake and low birth weight: a population-based case-control study. , 1998, American journal of epidemiology.

[28]  D. Altman,et al.  Calculating correlation coefficients with repeated observations: Part 2—correlation between subjects , 1995, BMJ.

[29]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[30]  J. Weigelt,et al.  Periodontal status and preterm low birth weight: a case control study. , 2005, Journal of periodontal research.

[31]  R. Caldeyro-barcia,et al.  A simplified method for diagnosis of gestational age in the newborn infant. , 1978, The Journal of pediatrics.

[32]  C. M. Figueredo,et al.  Association between periodontitis and low birth weight: a case-control study. , 2005, Journal of clinical periodontology.

[33]  J. Sterne,et al.  The East London Study of Maternal Chronic Periodontal Disease and Preterm Low Birth Weight Infants: study design and prevalence data. , 1998, Annals of periodontology.

[34]  A. Dasanayake,et al.  The association between Porphyromonas gingivalis-specific maternal serum IgG and low birth weight. , 2001, Journal of periodontology.

[35]  R. Gagnon,et al.  The risks of adverse neonatal outcome among preterm small for gestational age infants according to neonatal versus fetal growth standards. , 2003, Pediatrics.

[36]  M. H. D. Benício,et al.  Tendência secular do peso ao nascer na cidade de São Paulo (1976-1998) , 2000 .