Intrauterine growth restriction, low birth weight, and preterm birth: adverse pregnancy outcomes and their association with maternal periodontitis.
BACKGROUND
It has been suggested that periodontitis is associated with systemic alterations such as adverse pregnancy outcomes. However, some conflicting results have been reported. This case-control study was conducted to determine the association between maternal periodontitis and preterm birth (PTB), low birth weight (LBW), and intrauterine growth restriction (IUGR).


METHODS
A total of 1,305 Brazilian women from multiethnic groups were enrolled and divided into four groups: control group (1,042 women who gave birth to infants with adequate gestational age and birth weight); PTB group (238 women, gestational age <37 complete weeks); LBW group (235 women, birth weight <2,500 g); and IUGR group (77 women who gave birth to infants with fetal growth retardation). Periodontitis was defined as the presence of at least four teeth with one or more sites with probing depth > or =4 mm and clinical attachment loss > or =3 mm. The effects of variables of interest, confounders, and interaction were tested through univariate and multivariate logistic regression tests.


RESULTS
After adjusting for variables of interest, maternal periodontitis was retained in the final model for PTB (odds ratio [OR] = 1.77; 95% confidence interval [CI]: 1.12 to 2.59), LBW (OR = 1.67; 95% CI: 1.11 to 2.51), and IUGR (OR = 2.06; 95% CI: 1.07 to 4.19). When the interaction between periodontitis and previous PTB was tested, an OR of 5.94 (P <0.001), 9.12 (P <0.001), and 18.90 (P <0.001) was observed for PTB, LBW, and IUGR, respectively.


CONCLUSIONS
Maternal periodontitis is associated with an increased risk for PTB, LBW, and IUGR. Results emphasize the importance of periodontal care in prenatal health programs.
Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Fernanda Mafra
FM
Siqueira
Luís Otávio Miranda
LO
Cota
José Eustáquio
JE
Costa
João Paulo Amaral
JP
Haddad
Angela Maria Quintão
AM
Lana
Fernando Oliveira
FO
Costa
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016015:Logistic Models; D010518:Periodontitis / Q000150:complications*; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000209:etiology*