Pre-term delivery and periodontal disease: a case-control study from Croatia.
OBJECTIVE
The aim of this report was to assess the strength and influence of periodontitis as a possible risk factor for pre-term birth (PTB) in a cohort of 81 primiparous Croatian mothers aged 18-39 years.


METHODS
PTB cases (n = 17; mean age 25 +/- 2.9 years; age range 20-33 years) were defined as spontaneous delivery after less than 37 completed weeks of gestation that were followed by spontaneous labour or spontaneous rupture of membranes. Controls (full-time births) were normal births at or after 37 weeks of gestation (n = 64; mean age 25 +/- 2.9 years; age range 19-39 years). Information on known risk factors and obstetric factors included the current pregnancy history, maternal age at delivery, pre-natal care, nutritional status, tobacco use, alcohol use, genitourinary infections, vaginosis, gestational age, and birth weight. Full-mouth periodontal examination was performed on all mothers within 2 days of delivery.


RESULTS
PTB cases had significantly worse periodontal status than controls (p = 0.008). Multivariate logistic regression model, after controlling for other risk factors, demonstrated that periodontal disease is a significant independent risk factor for PTB, with an adjusted odds ratio of 8.13 for the PTB group (95% confidence interval 2.73-45.9).


CONCLUSIONS
Periodontal disease represents a strong, independent, and clinically significant risk factor for PTB in the studied cohort. There are strong indicators that periodontal therapy should form a part of preventive prenatal care in Croatia.
Bosnjak
Andrija
A
Department of Periodontology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia. bosnjak@sfzg.hr
Relja
Tomislav
T
Vucićević-Boras
Vanja
V
Plasaj
Hrvoje
H
Plancak
Darije
D
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D001424:Bacterial Infections / Q000150:complications; D001724:Birth Weight; D016022:Case-Control Studies; D015331:Cohort Studies; D017523:Croatia; D005260:Female; D052776:Female Urogenital Diseases / Q000150:complications; D005865:Gestational Age; D006801:Humans; D008423:Maternal Age; D009752:Nutritional Status; D010298:Parity; D017622:Periodontal Attachment Loss / Q000150:complications; D010518:Periodontitis / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications; D047928:Premature Birth / Q000209:etiology*; D011295:Prenatal Care; D012307:Risk Factors; D012907:Smoking; D016585:Vaginosis, Bacterial / Q000150:complications