Periodontal treatment during pregnancy and birth outcomes: a meta-analysis of randomised trials
Corresponding Author
Ajesh George BDS MPH PhD
Centre for Applied Nursing Research, South Western Sydney Local Health Network/University of Western Sydney
Dr Ajesh George, Centre for Applied Nursing Research, South Western Sydney Local Health Network/School of Nursing and Midwifery, University of Western Sydney, Liverpool BC, Locked Bag 7103, NSW 1871, Australia. Email: [email protected]Search for more papers by this authorSimin Shamim BN MBBS Student
Centre for Applied Nursing Research, South Western Sydney Local Health Network/University of Western Sydney
Search for more papers by this authorMaree Johnson RN BAppSci MAppSci PhD
Centre for Applied Nursing Research, School of Nursing and Midwifery, College of Health and Science, University of Western Sydney
Search for more papers by this authorShilpi Ajwani BDS PhD
Oral Health Research, Sydney & South Western Sydney Local Health Networks Oral Health Services and Sydney Dental Hospital
Faculty of Dentistry, University of Sydney
Search for more papers by this authorSameer Bhole BDS MDSc FICD MRACDS (DPH)
Oral Health Research, Sydney & South Western Sydney Local Health Networks Oral Health Services and Sydney Dental Hospital
Faculty of Dentistry, University of Sydney
Search for more papers by this authorAnthony Blinkhorn BDS MSc PhD
Faculty of Dentistry, University of Sydney
Search for more papers by this authorSharon Ellis RN RM MCN BHSM
Camden and Campbelltown Hospitals, South Western Sydney Local Health Network
Search for more papers by this authorKaren Andrews B.Optom Grad Dip IM-Lib
Ken Merten Library, Liverpool Hospital, South Western Sydney Local Health Network, Sydney, New South Wales, Australia
Search for more papers by this authorCorresponding Author
Ajesh George BDS MPH PhD
Centre for Applied Nursing Research, South Western Sydney Local Health Network/University of Western Sydney
Dr Ajesh George, Centre for Applied Nursing Research, South Western Sydney Local Health Network/School of Nursing and Midwifery, University of Western Sydney, Liverpool BC, Locked Bag 7103, NSW 1871, Australia. Email: [email protected]Search for more papers by this authorSimin Shamim BN MBBS Student
Centre for Applied Nursing Research, South Western Sydney Local Health Network/University of Western Sydney
Search for more papers by this authorMaree Johnson RN BAppSci MAppSci PhD
Centre for Applied Nursing Research, School of Nursing and Midwifery, College of Health and Science, University of Western Sydney
Search for more papers by this authorShilpi Ajwani BDS PhD
Oral Health Research, Sydney & South Western Sydney Local Health Networks Oral Health Services and Sydney Dental Hospital
Faculty of Dentistry, University of Sydney
Search for more papers by this authorSameer Bhole BDS MDSc FICD MRACDS (DPH)
Oral Health Research, Sydney & South Western Sydney Local Health Networks Oral Health Services and Sydney Dental Hospital
Faculty of Dentistry, University of Sydney
Search for more papers by this authorAnthony Blinkhorn BDS MSc PhD
Faculty of Dentistry, University of Sydney
Search for more papers by this authorSharon Ellis RN RM MCN BHSM
Camden and Campbelltown Hospitals, South Western Sydney Local Health Network
Search for more papers by this authorKaren Andrews B.Optom Grad Dip IM-Lib
Ken Merten Library, Liverpool Hospital, South Western Sydney Local Health Network, Sydney, New South Wales, Australia
Search for more papers by this authorAbstract
Objective The objective of this review was to conduct a meta-analysis of all up-to-date randomised control trials to determine whether periodontal treatment during pregnancy has the potential of reducing preterm birth and low birth weight incidence.
Methods Bibliographic databases MEDLINE (1966–present), EMBASE (1980–present), CINAHL (1982–present) and the Cochrane library up to and including 2010 Issue 10 were searched. The reference list of included studies and reviews were also searched for additional literature. Eligible studies were, published and ongoing randomised control trials that compared pregnancy outcomes for pregnant women who received periodontal treatment during the prenatal period. Two of the investigators independently assessed the studies and then extracted and summarised data from eligible trials. Extracted data were entered into Review Manager software and analysed.
Results A total of 5645 pregnant women participated in the 10 eligible trials. Meta-analysis found that periodontal treatment significantly lowered preterm birth (odd ratio 0.65; 95% confidence interval, 0.45–0.93; P = 0.02) and low birth weight (odd ratio 0.53; 95% confidence interval, 0.31–0.92; P = 0.02) rates while no significant difference was found for spontaneous abortion/stillbirth (odd ratio 0.71; 95% confidence interval, 0.43–1.16; P = 0.17). Moderate heterogeneity was observed among the studies for preterm birth and low birth weight. Subgroup analysis showed significant effect of periodontal treatment in pregnant women with low rate of previous preterm birth/low birth weight (odd ratio 0.35; 95% confidence interval, 017–0.70; P = 0.003) and less severe periodontal disease (odd ratio 0.49; confidence interval, 028–0.87; P = 0.01) as defined by probing depth.
Conclusion The cumulative evidence suggests that periodontal treatment during pregnancy may reduce preterm birth and low birth weight incidence. However, these findings need to be further validated through larger more targeted randomised control trials.
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