Research

A prospective study to investigate the relationship between periodontal disease and adverse pregnancy outcome

  • British Dental Journal volume 197, pages 251258 (11 September 2004)
  • doi:10.1038/sj.bdj.4811620
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Abstract

Objective This study aimed to investigate a relationship between maternal periodontal disease and preterm birth, low birth weight and late miscarriage.

Design Prospective study in a single centre.

Setting Guy's and St Thomas' Hospital Trust, London, UK between August 1998 and July 2001.

Subjects and Methods Pregnant women were recruited on attending an ultrasound scan at approximately 12 weeks of pregnancy. Subjects completed a questionnaire and underwent periodontal examination.

Main outcome measures Plaque and bleeding scores, pocket probing depth and loss of attachment. Pregnancy outcome data was collected retrospectively, including gestational age and birth weight at delivery.

Results Data were collected for 3,738 subjects. Regression analysis indicated that there were no significant relationships between the severity of periodontal disease and either preterm birth (PTB) or low birth weight (LBW). In contrast, there did appear to be a correlation between poorer periodontal health and those that experienced a late miscarriage.

Conclusions There was no association between either preterm birth or low birth weight and periodontal disease in this population. There is evidence of a correlation between markers of poorer periodontal health and late miscarriage.

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References

  1. 1.

    , , , et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 1996; 67: 1103–1113.

  2. 2.

    , , , , , . Periodontal infection and preterm birth. J Am Dent Assoc 2001; 132: 875–888.

  3. 3.

    , , . Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomized controlled trial. J Periodontol 2002; 73: 911–924.

  4. 4.

    , , , , , . Maternal periodontal disease and preterm low birth weight: case-control study. J Dent Res 2002; 81: 313–318.

  5. 5.

    , , . Is periodontitis associated with an increased risk of coronary heart disease and preterm and/or low birth weight births? J Clin Periodontol 2002; 29 (Suppl 3): 22–36.

  6. 6.

    World Health Organisation. International classification of diseases. 1975 revision. Volume 1. Geneva: WHO, 1977.

  7. 7.

    , , , , . Neurologic and developmental disability after extremely preterm birth. New Engl J Med 2000; 343: 378–384.

  8. 8.

    . Fetal and infant origins of adult disease. London: Br Med J 1990; 17:1111.

  9. 9.

    , , , , , . The contribution of mild and moderate preterm birth to infant mortality. J Am Med Assoc 2000; 284: 843–849.

  10. 10.

    , . Birth counts. Statistics of pregnancy and childbirth. 2 edn. Norwich: The Stationery Office. 2000.

  11. 11.

    , . Obstetrics by ten teachers. 17 edn. New York: Arnold. 2000.

  12. 12.

    . Current view of risk factors for periodontal diseases. J Periodontol 1996; 67: 1041–1049.

  13. 13.

    , , , , . Natural history of periodontal disease in adults: Findings from the Tecumseh Periodontal Disease Study: 1959-1987. J Dent Res 1990; 69: 430–435.

  14. 14.

    , . Effect of non-surgical treatment on gingival bleeding in smokers and non-smokers. Acta Odontol Scand 1986; 44: 85–89.

  15. 15.

    . Cigarette smoking as a risk factor in chronic periodontal disease. Community Dent Oral Epidemiol 1989; 17: 245–247.

  16. 16.

    , , , , , . Evidence for cigarette smoking as a major risk factor for periodontitis. J Periodontol 1993; 64: 16–23.

  17. 17.

    , , , , . UK multicentre project on assessment of risk of trisomy 21 by maternal age and fetal nuchal-translucency thickness at 10-14 weeks of gestation. Lancet 1998; 352: 343–346.

  18. 18.

    , , , et al. Periodontal health of London women during early pregnancy. Br Dent J 2001; 191: 570–573.

  19. 19.

    , , . Intrauterine infection and preterm delivery. New Engl J Med 2000; 342: 1500–1507.

  20. 20.

    . Prematurity: Infection as an etiologic factor. Obstet Gynecol 1983; 62: 137–144.

  21. 21.

    . Preterm birth: Associations with genital and possibly oral microflora. Ann Periodontol 1998; 3: 222–232.

  22. 22.

    , . Periodontal disease in pregnancy, 3. Response to local treatment. Acta Odontol Scand 1966; 24: 747–759.

  23. 23.

    , , , , . A longitudinal investigation of the periodontal changes during pregnancy and fifteen months post-partum: Part 2. J Periodontol 1971; 42: 653–657.

  24. 24.

    . Periodontal status during pregnancy. J Periodontol 1974; 45: 641–643.

  25. 25.

    , , , . Gingivitis and periodontal disease in pregnancy. J Periodontol 1974; 47: 641–643.

  26. 26.

    , , , , . Experimental gingivitis during pregnancy and post-partum: clinical, endocrinological, and microbiological aspects. J Clin Periodol 1994; 21: 549–558.

  27. 27.

    . (Ed.) NHS maternity statistics, England: 1989-90 to 1994-95. 1997 London: Department of Health, 1997.

  28. 28.

    . (Ed.) NHS Maternity Statistics, England: 1995-96 to 1997-98. London: Department of Health, 2001.

  29. 29.

    , , , et al. Adult Dental Health Survey. Oral Health in the United Kingdom 1998. London: Office for National Statistics, 2000.

  30. 30.

    , , . Periodontal diseases in the United States population. J Periodontol 1998; 69: 269–278.

  31. 31.

    , , . Validation of smoking status in clinical research into inflammatory periodontal disease. J Clin Periodol 2001; 28: 715–722.

  32. 32.

    , , , et al. Cocaine and tobacco use and the risk of spontaneous abortion. New Engl J Med 1999; 340: 333–339.

  33. 33.

    , , . Trends in smoking during pregnancy in England, 1992-7: quota sampling surveys. Br Med J 1998; 317: 728.

  34. 34.

    , , . Bias induced by self-reported smoking on periodontitis-systemic disease associations. J Dent Res 2003; 82: 345–349.

  35. 35.

    , . Clinical assessment of periodontitis in young adults - evaluation of probing depth and partial recording methods. Community Dent Oral Epidemiol 1996; 24: 56–61.

  36. 36.

    , . Methodological aspects of epidemiological studies of periodontal disease. Periodontol 2000 2002; 29: 11–30.

  37. 37.

    , . Medical Statistics. 3rd edn, Chichester: John Wiley & Sons Ltd, 1999.

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Acknowledgements

The authors wish to acknowledge the invaluable advice, assistance and cooperation of colleagues and support staff in the Department of Fetal Medicine and the Fetal Health Research Group, Guy's and St Thomas' Hospital Trust without which this study would have been impossible; particularly Dr Susan Bewley, Mr Darryl Maxwell and Professor Lucilla Poston. The authors also acknowledge the assistance of colleagues in the Department of Periodontology and Preventive Dentistry, GKT Dental Institute and Colgate-Palmolive, UK for supplying oral hygiene packs for the subjects. This work was undertaken with funding from the DHSC - London, Research and Development, Responsive Funding Programme. The views expressed in the publication are those of the authors and not necessarily those of the NHS or the Department of Health.

Author information

Affiliations

  1. Specialist Registrar, Restorative Dentistry, Floor 21 Guy's Tower, Guy's, King's, and St. Thomas' Dental Institute, King's College, London SE1 9RT

    • S Moore
  2. Senior Lecturer and Honorary Consultant, Floor 21 Guy's Tower, Guy's, King's, and St. Thomas' Dental Institute, King's College, London SE1 9RT

    • M Ide
  3. Senior Scientific Officer, Dental Clinical Research, Floor 17 Guy's Tower, Guy's, King's, and St. Thomas' Dental Institute, King's College, London SE1 9RT

    • P Y Coward
  4. Research Midwife, Floor 21 Guy's Tower, Guy's, King's, and St. Thomas' Dental Institute, King's College, London SE1 9RT

    • M Randhawa
  5. Clinical Demonstrator, Floor 21 Guy's Tower, Guy's, King's, and St. Thomas' Dental Institute, King's College, London SE1 9RT

    • E Borkowska
  6. Clinical Demonstrator, Periodontology and Preventive Dentistry, Floor 21 Guy's Tower, Guy's, King's, and St. Thomas' Dental Institute, King's College, London SE1 9RT

    • R Baylis
  7. Senior Lecturer, Dental Clinical Research, Floor 17 Guy's Tower, Guy's, King's, and St. Thomas' Dental Institute, King's College, London SE1 9RT

    • R F Wilson

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Corresponding author

Correspondence to S Moore.