Maternal periodontal disease and perinatal mortality.
BACKGROUND
Periodontal disease has been associated with increased perinatal mortality.


OBJECTIVE
To examine the association between maternal periodontal disease and perinatal mortality.


METHODS
We performed a retrospective and prospective matched case-control study of women with unexplained perinatal mortality at more than 20 weeks gestational age. Women were matched for socioeconomic status, smoking status and time since delivery. All women underwent a detailed periodontal examination and completed a questionnaire describing oral health symptoms. No intervention took place.


RESULTS
Fifty-three women who had experienced a perinatal death and 111 controls completed the study. Thirty-two women were recruited retrospectively and 21 women were recruited prospectively. Twenty-three (43.4%) women who had experienced a perinatal death and 27 (24.3%) controls had periodontal disease. There were no differences in oral health behaviours or symptoms between cases and controls. Perinatal death was associated with periodontal disease (odds ratio (OR) 2.34, 95% confidence interval (CI) 1.05, 5.47). Periodontal disease was more strongly associated with perinatal mortality due to extreme prematurity (OR 3.60, 95% CI 1.20, 12.04). Multivariate analysis showed this relationship to be consistent after inclusion of higher parity, country of birth, advanced maternal age and maternal obesity in the model (OR 4.56, 95% CI 1.25, 21.27).


CONCLUSIONS
Maternal periodontal disease may contribute to perinatal mortality, especially that caused by extreme prematurity.
School Women's and Infants' Health, University of Western Australia, Perth, Western Australia, Australia. ashub@internode.on.net
Alexis
A
Shub
Clement
C
Wong
Belinda
B
Jennings
Jonathan R
JR
Swain
John P
JP
Newnham
D000328:Adult; D001315:Australia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D016017:Odds Ratio; D054238:Perinatal Mortality; D010510:Periodontal Diseases / Q000150:complications* / Q000401:mortality*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000401:mortality*; D011446:Prospective Studies; D012189:Retrospective Studies; D050497:Stillbirth / Q000453:epidemiology*