The Effectiveness of Periodontal Disease Treatment During Pregnancy in Reducing the Risk of Experiencing Preterm Birth and Low Birth Weight : A meta-analysis

ABSTRACT BackgroundTreating periodontal disease during pregnancy to improve outcomes is controversial, and the results of randomized controlled trials (RCTs) are conflicting. The authors performed meta-analysis of these RCTs to assess the overall effect of treating periodontal disease during pregnancy.Types of Studies ReviewedThe authors performed a meta-analysis of studies found by means of two database aggregators OvidSP (12 databases) and EBSCOhost (11 databases). They included RCTs in pregnant women with periodontal disease who were assigned to a treatment arm (scaling and root planing with polishing) or a control arm (no treatment or only prophylaxis).ResultsTen RCTs met the inclusion criteria for preterm birth (PTB), and eight RCTs met the inclusion criteria for low birth weight (LBW). The odds ratio of PTB in the treatment group was 0.589 (95 percent confidence interval [CI] = 0.396–0.875) and of LBW was 0.717 (95 percent CI = 0.440–1.169). Level of bias was the only significant predictor (P < .001) in subgroup analysis. High-quality studies (studies with low bias), which included 71.2 percent of participants, yielded the pooled estimates of 1.082 (95 percent CI = 0.891–1.314) for PTB and 1.181 (95 percent CI = 0.960–1.452) for LBW.Clinical ImplicationsPooled results from the highest-quality RCTs do not support the hypothesis of a reduction of PTB or LBW in women who are treated for periodontal disease during pregnancy.