Periodontal disease is common as is pregnancy and preterm labour is a complication in 10-15% of all pregnancies. It is therefore not unsurprising that an association between periodontal disease and pre-term labour has been noted in a number of studies. The aim of this latest review was quantify the relationship between periodontal disease, preterm birth and low birth weight in order to explore the reasons for the ongoing controversies surrounding this issue.
The authors took a standard approach to this systematic review using the PRISMA guidelines searching the Medline, Embase, BIOSIS, LILACS, Scopus, the Cochrane Central Register of Controlled Trials, the ISI Web of Science and IBECS databases for randomised controlled trials that allocated pregnant women to receive treatment with scaling and root planing, versus no treatment or prophylaxis. The outcomes of interest were preterm birth (< 37 weeks), low birth weight (< 2,500g). Trials were assessed for risk of bias.
- Thirteen trials involving 3,576 women in intervention groups with 3,412 women receiving usual care were included.
- Meta-analysis found a non-significant reduction of
- preterm births (RR = 0.90; 95%CI: 0.68-1.19) and
- low birth weights (RR = 0.92; 95%CI: 0.71-1.20).
- a funnel plot revealed clear evidence of publication bias.
The authors concluded
Primary periodontal care during pregnancy cannot be considered an efficient way of reducing the incidence of preterm birth.
This is a component and well-presented meta-analysis of the relationship between periodontal treatment and obstetric outcomes. However, it is worth asking how many more reviews we need on this topic when the number of primary studies is low. A quick and dirty search of Medline at least 17 previous reviews ( see links) of this area since 2002 so a more comprehensive search strategy could well find additional ones. The search strategy in this current review only identified 8 other primary studies (which were excluded) in addition to the 13 that formed this analysis.
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