title: Periodontal disease activity measured by the benzoyl-DL-arginine-naphthylamide test is associated with preterm births.
abstract: BACKGROUND
  Infection is a risk factor for preterm birth. This study was conducted in the field and addressed the link between periodontal pathogens measured with the benzoyl-DL-arginine-naphthylamide (BANA) test and preterm birth.
  
  
  METHODS
  This prospective study was performed in Changhua, Taiwan. Periodontal examinations included the plaque index, papillary bleeding scores, and measurement of the BANA enzyme in plaque samples at the second and third trimesters. Independent variables included maternal demographic characteristics, previous pregnancy histories, risk factors, plaque and gingivitis scores, and current pregnancy outcomes.
  
  
  RESULTS
  There were 19 (7%) preterm deliveries among the 268 subjects. A history of a previous preterm birth and low birth weight, frequency of prenatal visits, preterm uterine contractions, antepartum hemorrhages, placenta previae, and preterm premature rupture of membranes were significantly related to preterm birth (P = 0.035, 0.027, <0.001, 0.025, 0.006, 0.014, and <0.001, respectively). Maternal weight gain was higher with a normal term delivery (P = 0.003). Multivariable logistic regression analyses showed that the number of BANA-infected sites in the third trimester (odds ratio [OR]: 5.89; 95% confidence interval [CI]: 1.5 to 31.6), maternal weight gain (OR: 0.78; 95% CI: 0.65 to 0.91), antepartum hemorrhages (OR: 10.0; 95% CI: 2.2 to 46.9), and preterm premature rupture of membranes (OR: 12.6; 95% CI: 3.97 to 42.71) had significant influences on preterm-birth outcomes.
  
  
  CONCLUSIONS
  BANA-positive plaque in the third trimester was associated with preterm births after controlling for other risk factors. The BANA test can be used to screen pregnant women at chairside and/or bedside to apply suitable intervention tactics.
authors.affiliation: Department of Orthodontic and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1078, USA. pedochan@umich.edu
authors.forename: Hui-Chen
authors.initials: HC
authors.lastname: Chan
authors.forename: Chen-Tsai
authors.initials: CT
authors.lastname: Wu
authors.forename: Kathleen B
authors.initials: KB
authors.lastname: Welch
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Loesche
mesh_terms: D000293:Adolescent; D000328:Adult; D001587:Benzoylarginine-2-Naphthylamide / Q000032:analysis*; D003773:Dental Plaque / Q000201:enzymology; D003774:Dental Plaque Index; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D005884:Gingival Hemorrhage / Q000145:classification; D005891:Gingivitis / Q000145:classification; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature; D010510:Periodontal Diseases / Q000145:classification* / Q000201:enzymology; D010512:Periodontal Index; D010923:Placenta Previa; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D047928:Premature Birth / Q000209:etiology*; D011295:Prenatal Care; D011446:Prospective Studies; D012307:Risk Factors; D014590:Uterine Contraction / Q000502:physiology; D014592:Uterine Hemorrhage / Q000150:complications; D055815:Young Adult
chemical_list: D001587:Benzoylarginine-2-Naphthylamide