title: Maternal periodontal disease in early pregnancy and risk for a small-for-gestational-age infant.
abstract: OBJECTIVE
  The objective of the study was to determine whether periodontal disease is associated with delivery of a small-for-gestational-age infant.
  
  
  METHODS
  In a prospective study of oral health, periodontal disease was categorized as health, mild, or moderate/severe on the basis of clinical criteria. Small for gestational age was defined as birth weight less than the 10th percentile for gestational age. A risk ratio (95th percentile confidence interval) for a small-for-gestational-age infant among women with moderate or severe periodontal disease was calculated.
  
  
  RESULTS
  Sixty-seven of 1017 women (6.6%) delivered a small-for-gestational-age infant, and 143 (14.3%) had moderate or severe periodontal disease. The small-for-gestational-age rate was higher among women with moderate or severe periodontal disease, compared with those with health or mild disease (13.8% versus 3.2% versus 6.5%, P < .001). Moderate or severe periodontal disease was associated with a small-for-gestational-age infant, a risk ratio of 2.3 (1.1 to 4.7), adjusted for age, smoking, drugs, marital and insurance status, and pre-eclampsia.
  
  
  CONCLUSIONS
  Moderate or severe periodontal disease early in pregnancy is associated with delivery of a small-for-gestational-age infant. Understanding the mechanism of periodontal disease-associated adverse pregnancy outcomes could lead to interventions to improve fetal growth.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Kim A
authors.initials: KA
authors.lastname: Boggess
authors.forename: James D
authors.initials: JD
authors.lastname: Beck
authors.forename: Amy P
authors.initials: AP
authors.lastname: Murtha
authors.forename: Kevin
authors.initials: K
authors.lastname: Moss
authors.forename: Steven
authors.initials: S
authors.lastname: Offenbacher
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D010510:Periodontal Diseases / Q000503:physiopathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index