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Am J Perinatol 2013; 30(07): 537-544
DOI: 10.1055/s-0032-1329687
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Treatment of Periodontal Disease and Prevention of Preterm Birth: Systematic Review and Meta-analysis

Amélie Boutin
1   Department of Social and Preventive Medicine, Université Laval, Québec, Canada
,
Suzanne Demers
2   Department of Obstetrics and Gynecology, Université Laval, Québec, Canada
,
Stéphanie Roberge
1   Department of Social and Preventive Medicine, Université Laval, Québec, Canada
,
Amélie Roy-Morency
2   Department of Obstetrics and Gynecology, Université Laval, Québec, Canada
,
Fatiha Chandad
3   Department of Dentistry, Université Laval, Québec, Canada
,
Emmanuel Bujold
1   Department of Social and Preventive Medicine, Université Laval, Québec, Canada
2   Department of Obstetrics and Gynecology, Université Laval, Québec, Canada
› Author Affiliations
Further Information

Publication History

10 June 2012

30 July 2012

Publication Date:
27 December 2012 (online)

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Abstract

Objective There is a controversy regarding the benefits of periodontal treatment during pregnancy. We aimed to evaluate its effect on the risk of preterm birth and to explore the heterogeneity between studies.

Study Design A systematic review and meta-analysis of randomized controlled trials were performed. Studies in which women were randomized for periodontal treatment versus no treatment were included. Pooled risk ratios (RRs) with their 95% confidence intervals (CIs) were calculated using random-effect models. A sensitivity analysis was performed.

Results Twelve randomized trials were included in the meta-analysis. Pooled estimates showed no significant reduction of preterm birth with periodontal treatment (RR: 0.89; 95% CI: 0.73 to 1.08). However, the substantial heterogeneity among studies (I2 = 52%) could be explained either by the risk of bias, the level of income, or by the use of chlorhexidine mouthwashes as a cointervention. Daily use of chlorhexidine mouthwash was associated with a reduction of preterm birth (RR: 0.69; 95% CI 0.50 to 0.95), with moderate heterogeneity among the five studies included (I2 = 43%).

Conclusion There is an important heterogeneity between randomized trials that evaluated the effect of periodontal treatment on the risk of preterm birth. Chlorhexidine mouthwash as a preventive agent should be further evaluated.

Keywords

pregnancy - periodontitis - preterm birth - meta-analysis
 

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