Periodontal treatment during pregnancy and birth outcomes : a meta-analysis of randomised trials

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 signiï¬cantly lowered preterm birth (odd ratio 0.65; 95% conï¬dence interval, 0.45-0.93; P = 0.02) and low birth weight (odd ratio 0.53; 95% conï¬dence interval, 0.31-0.92; P = 0.02) rates while no signiï¬cant difference was found for spontaneous abortion/stillbirth (odd ratio 0.71; 95% conï¬dence 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 signiï¬cant effect of periodontal treatment in pregnant women with low rate of previous preterm birth/low birth weight (odd ratio 0.35; 95% conï¬dence interval, 017-0.70; P = 0.003) and less severe periodontal disease (odd ratio 0.49; conï¬dence interval, 028-0.87; P = 0.01) as deï¬ned by probing depth. Conclusion The cumulative evidence suggests that periodontal treatment during pregnancy may reduce preterm birth and low birth weight incidence. However, these ï¬ndings need to be further validated through larger more targeted randomised control trials.