Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomized controlled trial.
BACKGROUND
Recent studies have suggested that periodontal disease is a risk factor for preterm low birth weight (PLBW). A randomized controlled trial was undertaken to help further evaluate the proposed association between periodontal disease and PLBW.


METHODS
Four hundred pregnant women with periodontal disease, aged 18 to 35, were enrolled while receiving prenatal care in Santiago, Chile. Women were randomly assigned to either an experimental group (n = 200), which received periodontal treatment before 28 weeks of gestation or to a control group (n = 200) which received periodontal treatment after delivery. Previous and current pregnancies and known risk factors were obtained from patient medical records and interviews. The primary outcome assessed was the delivery at less than 37 weeks of gestation or an infant weighing less than 2,500 g.


RESULTS
Of the 400 women enrolled, 49 were excluded from the analyses for different reasons. The incidence of PLBW in the treatment group was 1.84% (3/163) and in the control group was 10.11% (19/188), (odds ratio [OR] 5.49, 95% confidence interval [CI] 1.65 to 18.22, P= 0.001). Multivariate logistic regression analysis showed that periodontal disease was the strongest factor related to PLBW (OR 4.70, 95% CI 1.29 to 17.13). Other factors significantly associated with such deliveries were: previous PLBW (OR 3.98, 95% CI 1.11 to 14.21), less than 6 prenatal visits (OR 3.70, 95% Cl 1.46 to 9.38), and maternal low weight gain (OR 3.42, 95% CI 1.16 to 10.03).


CONCLUSIONS
Periodontal disease appears to be an independent risk factor for PLBW. Periodontal therapy significantly reduces the rates of PLBW in this population of women with periodontal disease.
López
Néstor J
NJ
Department of Conservative Dentistry, Section of Periodontics, Faculty of Dentistry, University of Chile, Santiago. nlopez@interactiva.cl
Smith
Patricio C
PC
Gutierrez
Jorge
J
D000293:Adolescent; D000328:Adult; D016001:Confidence Intervals; D004245:DMF Index; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000145:classification; D005891:Gingivitis / Q000145:classification; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D016015:Logistic Models; D015999:Multivariate Analysis; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D016017:Odds Ratio; D009911:Oral Hygiene Index; D017622:Periodontal Attachment Loss / Q000145:classification; D010510:Periodontal Diseases / Q000628:therapy*; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000628:therapy*; D011256:Pregnancy Outcome; D011295:Prenatal Care; D017584:Reproductive History; D012307:Risk Factors; D016896:Treatment Outcome