Periodontal Disease and Preterm Birth: Results of a Pilot Intervention
Study (October 2003)
( This study suggests that there are definite benefits to the
mother and her unborn child by treating any periodontal (gum)
disease that may be present. It further states that the use
of antibiotics to treat the periodontal disease is NOT more effective
than the manual removal of bacterial buildup on the surfaces
of tooth roots. Postponement of treatment until after the
arrival of the baby, which is often suggested, appears to be contrary
to the health benefit of the therapy.- D. Babiec)
Marjorie K. Jeffcoat, John C. Hauth, Nico C. Geurs, Michael S.
Reddy,
Suzanne P. Cliver, Pamela M. Hodgkins, and Robert L. Goldenberg
Background: Previous case-control and prospective studies have
shown
an association between the presence of periodontitis and the risk
of
preterm birth (PTB). The goal of this pilot trial was to determine
the
feasibility of conducting a trial to determine whether treatment
of
periodontitis reduces the risk of spontaneous preterm birth (SPTB).
Methods: Three hundred sixty-six (366) women with periodontitis
between 21 and 25 weeks' gestation were recruited and randomized
to
one of three treatment groups with stratification on the following
two
factors: 1) previous SPTB at <35 weeks and 2) body mass index
<19.8 or
bacterial vaginosis as assessed by gram stain. The treatment groups
consisted of: 1) dental prophylaxis plus placebo capsule; 2) scaling
and root planing (SRP) plus placebo capsule; and 3) SRP plus
metronidazole capsule (250 mg t.i.d. for one week). An additional
group of 723 pregnant women meeting the same criteria for
periodontitis and enrolled in a prospective study served as an
untreated reference group.
Results: The rate of PTB at <35 weeks was 4.9% in the prophylaxis
group, compared to 3.3% in the SRP plus metronidazole group and
0.8%
in the SRP plus placebo group (P = 0.75 and 0.12, respectively).
The
rate of PTB at <35 weeks was 6.3% in the reference group.Conclusions:
This trial indicates that performing SRP in pregnant women with
periodontitis may reduce PTB in this population. Adjunctive
metronidazole therapy did not improve pregnancy outcome. Larger
trials
will be needed to achieve statistical significance, especially
at less
than 35 weeks gestational age.
[J Periodontol 2003;74:1214-1218]
