title: Treatment of localized periodontal disease in pregnancy does not reduce the occurrence of preterm birth: results from the Periodontal Infections and Prematurity Study (PIPS).
abstract: OBJECTIVE
  The purpose of this study was to test whether treating periodontal disease (PD) in pregnancy will reduce the incidence of spontaneous preterm delivery (SPTD) at < or = 35 weeks of gestation.
  
  
  METHODS
  A multicenter, randomized clinical trial was performed. Subjects with PD were randomized to scaling and root planing (active) or tooth polishing (control). The primary outcome was the occurrence of SPTD at <35 weeks of gestation.
  
  
  RESULTS
  We screened 3563 subjects for PD; the prevalence of PD was 50%. Seven hundred fifty-seven subjects were assigned randomly; 378 subjects were assigned to the active group, and 379 subjects were assigned to the placebo group. Active treatment did not reduce the risk of SPTD at <35 weeks of gestation (relative risk, 1.19; 95% confidence interval [CI], 0.62-2.28) or composite neonatal morbidity (relative risk, 1.30; 95% CI, 0.83-2.04). There was a suggestion of an increase in the risk of indicated SPTD at <35 weeks of gestation in those subjects who received active treatment (relative risk, 3.01; 95% CI, 0.95-4.24).
  
  
  CONCLUSIONS
  Treating periodontal disease does not reduce the incidence of SPTD.
authors.affiliation: Department of Obstetrics and Gynecology, Washington University in St. Louis, School of Medicine, Campus Box 8064, 4911 Barnes-Jewish Hospital Plaza, St. Louis, MO 63110-1094, USA. maconesg@wustl.edu
authors.forename: George A
authors.initials: GA
authors.lastname: Macones
authors.forename: Samuel
authors.initials: S
authors.lastname: Parry
authors.forename: Deborah B
authors.initials: DB
authors.lastname: Nelson
authors.forename: Jerome F
authors.initials: JF
authors.lastname: Strauss
authors.forename: Jack
authors.initials: J
authors.lastname: Ludmir
authors.forename: Arnold W
authors.initials: AW
authors.lastname: Cohen
authors.forename: David M
authors.initials: DM
authors.lastname: Stamilio
authors.forename: Dina
authors.initials: D
authors.lastname: Appleby
authors.forename: Bonnie
authors.initials: B
authors.lastname: Clothier
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Marjorie
authors.initials: M
authors.lastname: Jeffcoat
mesh_terms: D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D010510:Periodontal Diseases / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D047928:Premature Birth / Q000517:prevention & control*