Effects of periodontal therapy on rate of preterm delivery: a randomized controlled trial.
OBJECTIVE
To test the effects of maternal periodontal disease treatment on the incidence of preterm birth (delivery before 37 weeks of gestation).


METHODS
The Maternal Oral Therapy to Reduce Obstetric Risk Study was a randomized, treatment-masked, controlled clinical trial of pregnant women with periodontal disease who were receiving standard obstetric care. Participants were assigned to either a periodontal treatment arm, consisting of scaling and root planing early in the second trimester, or a delayed treatment arm that provided periodontal care after delivery. Pregnancy and maternal periodontal status were followed to delivery and neonatal outcomes until discharge. The primary outcome (gestational age less than 37 weeks) and the secondary outcome (gestational age less than 35 weeks) were analyzed using a chi test of equality of two proportions.


RESULTS
The study randomized 1,806 patients at three performance sites and completed 1,760 evaluable patients. At baseline, there were no differences comparing the treatment and control arms for any of the periodontal or obstetric measures. The rate of preterm delivery for the treatment group was 13.1% and 11.5% for the control group (P=.316). There were no significant differences when comparing women in the treatment group with those in the control group with regard to the adverse event rate or the major obstetric and neonatal outcomes.


CONCLUSIONS
Periodontal therapy did not reduce the incidence of preterm delivery.


METHODS
I.
Offenbacher
Steven
S
From the Departments of Dental Ecology/Dental Research, Periodontology, and Biostatistics, and the Data and Statistical Coordinating Center, University of North Carolina, Chapel Hill, North Carolina; the Department of Maternal Fetal Medicine, Duke University, Durham, North Carolina; the Departments of Periodontics and Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, Texas; and the Departments of Periodontology and Obstetrics and Gynecology, University of Alabama, Birmingham, Alabama.
Beck
James D
JD
Jared
Heather L
HL
Mauriello
Sally M
SM
Mendoza
Luisto C
LC
Couper
David J
DJ
Stewart
Dawn D
DD
Murtha
Amy P
AP
Cochran
David L
DL
Dudley
Donald J
DJ
Reddy
Michael S
MS
Geurs
Nicolaas C
NC
Hauth
John C
JC
D000328:Adult; D012534:Dental Scaling; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D010510:Periodontal Diseases / Q000473:pathology / Q000628:therapy*; D010512:Periodontal Index; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000453:epidemiology*; D011295:Prenatal Care; D012307:Risk Factors; D055815:Young Adult
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