Maternal periodontal disease and preterm birth: a case-control study

Resumo

OBJECTIVES: Periodontal disease can be a source of subclinical and persistent infection that may induce systemic inflammatory responses that increase the risk of preterm birth. The goal of this study was to establish whether periodontal disease is a risk factor for preterm birth, and to evaluate the association of this risk with gestational age.
METHODS: This case-control study included postpartum women with singleton gestations; 53 women who gave birth before the 37^th week (cases) were compared to 79 women with term deliveries (controls). Full-mouth clinical periodontal parameters were determined within 72 h after delivery.
RESULTS: The prevalence of periodontal disease was 41% (54/132). The preterm birth cases showed a significantly higher proportion of bleeding than the term birth controls (86.7% versus 68%, p = 0.026) and a greater maximum periodontal pocket depth on probing (3.9 ± 1.6 mm versus 3.2 ± 1 mm, p = 0.043). No differences in previous periodontal disease, attachment loss, or the percentage of periodontal disease were detected between the study groups. Logistic regression revealed that preterm birth was associated with the bleeding index (adjusted odds ratio 4.19; 95% CI: 1.28 - 13.69, p = 0.018) and with periodontal pocket depth (5.14; 95% CI: 1.50 - 17.6, p = 0.009). The risk of preterm birth associated with periodontal disease decreased as gestational age increased. In addition, the population attributable risk was 16% overall; this risk increased as gestational age decreased.
CONCLUSION: In this study population, only the bleeding index and periodontal pocket depth were risk factors for preterm birth; increased risk was associated with greater prematurity.