This cross-sectional study included 1305 Brazilian women who were 18 to 35 years old and gave birth in a public clinic between February 2004 and June 2005. A total of 1042 were considered to be control mothers with babies weighing 2500 g or more. A total of 263 mothers were considered cases, defined as having either low birth weight (LBW) (<2500 g), preterm birth (PTB) (<37 weeks gestation) or intrauterine growth restriction (IUGR) (diagnosed by an obstetrician during prenatal visits using ultrasound, amniotic fluid, fetal growth, and symmetry). The same 263 cases were divided into 238 PTB, 235 LBW, or 77 IUGR. Maternal periodontitis status was measured within 48 hours of birth and defined as presence of 4 or more teeth with pocket depth 4 mm or more and clinical attachment loss of 3 mm or more at the same site. Other variables included age, educational level, prenatal visits, chronic hypertension, conjugal stability, diabetes, primiparity (first birth), smoking, drug and alcohol use during pregnancy and premature birth.Exposure
The primary exposure was maternal periodontitis as measured within 48 hours post-deliveryMain Outcome Measures
Preterm birth, low birth weight, and intrauterine growth restrictionMain Results
The authors reported that presence of maternal periodontitis within 48 hours after birth was significantly associated with PTB (Odds Ratio [OR] = 1.77; 95% Confidence Interval [CI] = 1.12-2.59), LBW (OR = 1.6; CI = 1.11-2.51), and IUGR(OR = 2.06; CI = 1.00-4.19) in separate multivariate logistic regression models. The authors also indicated that the ORs for interaction between maternal periodontitis and previous PTB were significant at 5.94, 9.12, and 18.90 for PTB, LBW, and IUGR, respectively. All models controlled for chronic hypertension, primiparity, 6 or more prenatal visits, previous PTB, interaction between maternal periodontitis and 6 or fewer prenatal visits, and the interaction between maternal periodontitis and previous PTB. The model for PTB also included a variable for previous abortion and the LBW model controlled for maternal age of 30 years or older.Conclusions
The authors concluded that there was a risk association between maternal periodontitis and the adverse pregnancy outcomes of PTB, LBW, and intrauterine growth restriction. They also concluded that these results emphasize the importance of periodontal care in prenatal health programs.