Preterm birth and periodontitis: a dilemma of current obstetrics

Abstract

Objective In current obstetric literature, the influence of periodontal disease on adverse perinatal outcome is a matter of debate. In this prospective cohort study, we aimed to investigate whether there is an association between periodontal status and preterm birth (PTB) via previously unused methodology. Methods In this prospective cohort study, we examined the periodontal status of mothers within 24 hours following birth. In total, 226 puerperal women were examined and placed in two groups; a PTB group consisting of 71 patients, and a term birth (TB) group consisting of 155 patients. All risk factors known to be etiologic factors for PTB were excluded. The patients were classified into three main groups in both groups based on oral examination findings: gingivitis (G), periodontitis (P), and healthy (H). Results Both groups were identical in terms of demographic factors. Regarding possibly influencing factors including smoking, passive smoking and tooth brushing habits, both groups were also identical. The distribution of G, P and H among the groups were similar and the difference was not significant (p=1). p-values among the PTB and TB groups were 40.8% and 40.6%, respectively, and the difference was not significant. When collected data were reanalyzed by splitting the PTB group into early and late PTB, the results were similar and the difference was not significant. Conclusion The confusion over this conflicting association likely results from confounding factors, other factors that can cause PTB and lack of consensus over the diagnostic criteria for periodontal disease. Finally, our prospective cohort study, which strictly excluded possible confounding variables, has not confirmed any association between periodontitis and preterm birth.