title: Synergistic effect of maternal obesity and periodontitis on preterm birth in women with pre-eclampsia: a prospective study.
abstract: The aim of this study was to investigate if pregnant women with both obesity and periodontitis are more likely to experience preterm birth (PTB) in women with pre-eclampsia (PE) than pregnant women with only obesity or only periodontitis.
  
  
  
  The study examined a total of 328 pregnant women at 21-24 weeks of gestation. Overweight and obesity was defined based on criteria proposed by the WHO Expert Consultation. Periodontal conditions were assessed by measuring periodontal clinical attachment loss. PTB was defined as delivery at <37 weeks, and PE was defined as blood pressure higher than 140/90 mmHg on two separate occasions with at least 1+ proteinuria on a random urine screen after the 20th week of pregnancy.
  
  
  
  After adjusting for other important cofactors, pregnant women with periodontitis were 5.56 times [95% confidence interval (CI) = 1.22-25.39] more likely to have PTB with PE than women without periodontitis. The association was much stronger (odds ratio = 15.94, 95% CI = 3.31-76.71) in women with both obesity and periodontitis.
  
  
  
  Our results of this study indicate that pregnant women with both pre-pregnancy obesity and periodontitis are significantly more likely to have PTB with PE than pregnant women with only periodontitis.
authors.affiliation: Department of Preventive and Public Health Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.|Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
authors.forename: Hyo-Jin
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Dental Hygiene, Baekseok University, Cheonan, Korea.
authors.forename: Jung-Eun
authors.initials: JE
authors.lastname: Ha
authors.affiliation: Appletree Oral Health Science R&D center, Bucheon, Korea.
authors.forename: Kwang-Hak
authors.identifier: 0000-0002-7671-2165
authors.initials: KH
authors.lastname: Bae
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009765:Obesity; D017622:Periodontal Attachment Loss; D010518:Periodontitis; D011225:Pre-Eclampsia; D011247:Pregnancy; D047928:Premature Birth; D011446:Prospective Studies
keywords: body mass index; obesity; periodontitis; pre-eclampsia; preterm birth