Preterm birth associated with periodontal and dental indicators: a pilot case-control study in a developing country

Abstract Introduction: Preterm delivery is a multifactorial health problem that represents a serious public health problem around the world. In recent years, there has been an increase in scientific evidence suggesting associations between oral health status (mainly periodontal disease and tooth loss) and an increased risk of systemic diseases and various adverse pregnancy outcomes. This study explores the association between indicators of oral health and preterm delivery in a sample of Mexican pregnant women. Materials and methods: A case-control study was carried out with 111 pregnant (36 cases, 75 controls) who received prenatal care and delivered in an obstetric hospital in Pachuca, Mexico. Clinical files were reviewed to obtain the necessary information for the variables studied. The dependent variable was preterm delivery and the independent variables were gingivitis, periodontitis, DMFT index and its components, the number of decayed teeth with pulpal exposure or endodontic lesions, age of the mother, education, alcohol use, smoking status, number of gestations, and sex of the newborn. Results: The average ages were similar between the cases and the controls (24.29 ± 5.42 versus 24.89 ± 5.67, p = .5781). Significant differences were observed with gingivitis (p < .01) and periodontitis (p < .001). In addition, when the severity of gingivitis or periodontitis increased, the percentage of cases of preterm delivery increased (p < .01). The average number of teeth lost was higher among the cases than among the controls (1.33 ± 1.89 versus 0.81 ± 1.82, p < .05). Conclusions: It was found that gingivitis, periodontitis, and tooth loss were associated with preterm delivery. It is necessary to carry out actions aimed at the preservation of oral health in pregnant patients to avoid adverse results. These findings indicate a likely association, but it needs to be confirmed by large and well-designed studies.

[1]  M. B. J. Camargo,et al.  Maternal periodontal disease and adverse perinatal outcomes: is there an association? A hospital-based case-control study , 2019, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[2]  Jun Zhang,et al.  Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis , 2018, The Lancet. Global health.

[3]  G. Lafaurie,et al.  Periodontal condition is associated with adverse perinatal outcomes and premature rupture of membranes in low-income pregnant women in Bogota, Colombia: a case–control study , 2018, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[4]  R. Flores-Ramírez,et al.  Periodontal Disease, Systemic Inflammation and the Risk of Cardiovascular Disease. , 2018, Heart, lung & circulation.

[5]  S. Keinänen-Kiukaanniemi,et al.  Association between periodontal condition and the development of type 2 diabetes mellitus—Results from a 15‐year follow‐up study , 2018, Journal of clinical periodontology.

[6]  Ji‐Won Kim,et al.  Rheumatoid arthritis is associated with early tooth loss: results from Korea National Health and Nutrition Examination Survey V to VI , 2018, The Korean journal of internal medicine.

[7]  K. Li,et al.  The directional and non‐directional associations of periodontitis with chronic kidney disease: A systematic review and meta‐analysis of observational studies , 2018, Journal of periodontal research.

[8]  A. Taneja,et al.  Environmental toxic metals in placenta and their effects on preterm delivery-current opinion , 2018, Drug and chemical toxicology.

[9]  A. Scheie,et al.  Biofilms and their properties , 2018, European journal of oral sciences.

[10]  A. Gilman‐Sachs,et al.  Inflammation induced preterm labor and birth. , 2018, Journal of reproductive immunology.

[11]  Jungsoon Choi,et al.  Poor Oral Health Predicts Higher 10-Year Cardiovascular Risk: A Propensity Score Matching Analysis , 2018, The Journal of cardiovascular nursing.

[12]  B. Mealey,et al.  Dental plaque–induced gingival conditions , 2018, Journal of periodontology.

[13]  M. Bravo,et al.  Chronic periodontitis is associated with erectile dysfunction. A case–control study in european population , 2018, Journal of clinical periodontology.

[14]  I. Velsko,et al.  Consistent and reproducible long-term in vitro growth of health and disease-associated oral subgingival biofilms , 2018, bioRxiv.

[15]  P. Lumbiganon,et al.  The global epidemiology of preterm birth. , 2018, Best practice & research. Clinical obstetrics & gynaecology.

[16]  Hye-Sun Shin.  Association between the number of teeth and hypertension in a study based on 13,561 participants , 2018, Journal of periodontology.

[17]  Fen Qin,et al.  Tooth loss and risk of cardiovascular disease and stroke: A dose-response meta analysis of prospective cohort studies , 2018, PloS one.

[18]  L. Manzoli,et al.  Dental caries and preterm birth: a systematic review and meta-analysis , 2018, BMJ Open.

[19]  J. Beck,et al.  Periodontal profile class is associated with prevalent diabetes, coronary heart disease, stroke, and systemic markers of C‐reactive protein and interleukin‐6 , 2018, Journal of periodontology.

[20]  C. Gyamfi‐Bannerman,et al.  Epidemiology of preterm birth. , 2017, Seminars in perinatology.

[21]  B. Nagoba,et al.  Assessment of periodontitis and its role in viridans streptococcal bacteremia and infective endocarditis , 2017, Indian heart journal.

[22]  C. Africa,et al.  Further evidence for periodontal disease as a risk indicator for adverse pregnancy outcomes. , 2017, International dental journal.

[23]  A. Sheikh,et al.  Reducing tobacco smoking and smoke exposure to prevent preterm birth and its complications. , 2017, Paediatric respiratory reviews.

[24]  A. Yitayeh,et al.  Relationship between periodontal disease and preterm low birth weight: systematic review , 2016, The Pan African medical journal.

[25]  J. Loyola-Rodríguez,et al.  Association between periodontitis, periodontopathogens and preterm birth: is it real? , 2016, Archives of Gynecology and Obstetrics.

[26]  S. Acharya,et al.  Risk Factors for Preterm Birth and Low Birth Weight Among Pregnant Indian Women: A Hospital-based Prospective Study , 2016, Journal of preventive medicine and public health = Yebang Uihakhoe chi.

[27]  P. Magnus,et al.  Alcohol consumption among first-time mothers and the risk of preterm birth: a cohort study. , 2016, Annals of epidemiology.

[28]  E. Ferrazzi,et al.  Adverse pregnancy outcomes and periodontitis: A systematic review and meta-analysis exploring potential association. , 2016, Quintessence international.

[29]  Z. Aleksic,et al.  The Association Between Periodontal Inflammation and Labor Triggers (Elevated Cytokine Levels) in Preterm Birth: A Cross-Sectional Study. , 2016, Journal of periodontology.

[30]  Qijun Wu,et al.  Associations between Passive Maternal Smoking during Pregnancy and Preterm Birth: Evidence from a Meta-Analysis of Observational Studies , 2016, PloS one.

[31]  I. Johansson,et al.  The Microbiome in Populations with a Low and High Prevalence of Caries , 2016, Journal of dental research.

[32]  A. Sekine,et al.  Tooth Loss and Atherosclerosis , 2015, Journal of dental research.

[33]  J. Bartova,et al.  Periodontitis as a Risk Factor of Atherosclerosis , 2014, Journal of immunology research.

[34]  P. Papapanou,et al.  Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes--systematic review. , 2013, Journal of periodontology.

[35]  N. Karimbux,et al.  Scaling and root planing treatment for periodontitis to reduce preterm birth and low birth weight: a systematic review and meta-analysis of randomized controlled trials. , 2012, Journal of periodontology.

[36]  S. Taschieri,et al.  Periodontal disease as a risk factor for adverse pregnancy outcomes: a systematic review and meta-analysis of case–control studies , 2012, Odontology.

[37]  J. Meurman,et al.  Postpartum oral health parameters in women with preterm birth , 2008, Acta odontologica Scandinavica.

[38]  Stella M. Yu,et al.  Periodontal Disease and Pregnancy Outcomes: State-of-the-Science , 2007, Obstetrical & gynecological survey.

[39]  J. Beck,et al.  Maternal periodontitis and prematurity. Part I: Obstetric outcome of prematurity and growth restriction. , 2001, Annals of periodontology.

[40]  J. Beck,et al.  Periodontal Infection as a Possible Risk Factor for Preterm Low Birth Weight. , 1996, Journal of periodontology.

[41]  H. Löe,et al.  PERIODONTAL DISEASE IN PREGNANCY. I. PREVALENCE AND SEVERITY. , 1963, Acta odontologica Scandinavica.

[42]  D. Barbirato,et al.  No association between periodontitis and preterm low birth weight: a case–control study , 2017, Archives of Gynecology and Obstetrics.