Association Between Periodontitis and Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis.
BACKGROUND
To the best of the authors' knowledge, there is no systematic review of the potential association between periodontitis and gestational diabetes mellitus (GDM) in the current literature. The aim of the present systematic review and meta-analysis is to search for scientific evidence regarding the association between periodontitis and GDM.


METHODS
The present study was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and registered (CRD2014010728) with PROSPERO (International prospective register for systematic reviews, University of York, York, UK). A search was conducted in three electronic databases without restrictions regarding language or date of publication. From 190 studies selected, 15 underwent full-text analysis. Eight studies were eligible (five cross-sectional and three case-control studies), and seven were entered in the meta-analysis. Meta-analysis was performed with tests for sensitivity and statistical heterogeneity. Summary effect measures were calculated by odds ratio (OR) and 95% confidence interval (CI).


RESULTS
There was a significant association between periodontitis and GDM in the meta-analyses of four cross-sectional studies (OR 1.67, 95% CI 1.20 to 2.32) and two case-control studies (OR 2.66, 95% CI 1.52 to 4.65). However, sensitivity tests for case-control studies showed a lack of consistency in data; when including one case-control study, the significance was null (meta-analysis of three case-control studies: OR 1.69, 95% CI 0.68 to 4.21).


CONCLUSIONS
There was substantial clinical, methodologic, and statistical heterogeneity among the studies. The scientific evidence cannot affirm a positive association between periodontitis and GDM. Future studies with different designs in distinct populations should be conducted to investigate this association.
Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Rafael Paschoal
RP
Esteves Lima
Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Renata Magalhães
RM
Cyrino
Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Bernardo
B
de Carvalho Dutra
Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Juliana
J
Oliveira da Silveira
Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Minas Gerais.
Carolina Castro
CC
Martins
Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Luis Otávio
LO
Miranda Cota
Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Fernando Oliveira
FO
Costa
D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational; D005260:Female; D006801:Humans; D010518:Periodontitis; D011247:Pregnancy; D011446:Prospective Studies
Diabetes mellitus; gestational diabetes; hyperglycemia; insulin resistance; periodontitis; risk factors