title: Periodontal infection and adverse pregnancy outcomes: a systematic review of epidemiological studies.
abstract: The objective of this systematic review was to evaluate analytical studies on periodontal disease as a possible risk factor for adverse pregnancy outcomes. A literature search of the MEDLINE, SciELO, and LILACS bibliographic databases and CAPES thesis database was conducted up to December 2005, covering epidemiological studies of periodontal disease and adverse pregnancy outcomes. Of the 964 papers identified, 36 analytical studies met the inclusion criteria. Twenty-six epidemiological studies reported associations between periodontal disease and adverse pregnancy outcomes. There was a clear heterogeneity between studies concerning measurement of periodontal disease and selection of type of adverse pregnancy outcome. Therefore no meta-analysis was performed. Most studies did not control for confounders, thus raising serious doubts about their conclusions. The methodological limitations of most studies did not allow conclusions concerning the effects of periodontal disease on adverse pregnancy outcomes. Larger and methodologically rigorous analytical studies using reliable outcomes and exposure measures are recommended.
authors.affiliation: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. mario@ensp.fiocruz.br
authors.forename: Mario Vianna
authors.initials: MV
authors.lastname: Vettore
authors.forename: Gabriela de Almeida
authors.initials: Gde A
authors.lastname: Lamarca
authors.forename: Anna Thereza Thomé
authors.initials: AT
authors.lastname: Leão
authors.forename: Filipe Brand
authors.initials: FB
authors.lastname: Thomaz
authors.forename: Aubrey
authors.initials: A
authors.lastname: Sheiham
authors.forename: Maria do Carmo
authors.initials: Mdo C
authors.lastname: Leal
mesh_terms: D001938:Brazil / Q000453:epidemiology; D016021:Epidemiologic Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D010510:Periodontal Diseases / Q000150:complications* / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors