Estudo caso-controle da associação entre periodontite materna e intercorrências gestacionais: parto pré-termo, baixo peso ao nascer, cresimento intra-uterino restrito e pré-eclâmpsia

Abstract

Background: It has been suggested that periodontitis is associated with systemic alterations such as adverse pregnancy outcomes. However, some conflicting results have been reported. This case-control study was conducted to determine the association between maternal periodontitis and preterm birth (PTB), low birth weight (LBW), and intrauterine growth restriction (IGR). Methods: 1,305 Brazilian women, from multiethnic groups, were enrolled and divided into: a) control group 1,042 women who gave birth to infants with adequate gestational age and birth weight; b) PTB group 238 women, gestational age <37 complete weeks; c) LBW group 235 women, birth weight <2,500g); d) IGR group 77 women who gave birth to infants with fetal growth retardation. Periodontitis was defined as the presence of 4 or more teeth with one or more sites at a probing depth of 4mm and a clinical attachment loss of 3mm. The effect of variables of interest, confounders, and interaction were tested trough univariate and multivariate logistic regression tests. Results: After adjusting for variables of interest, maternal periodontitis was retained in the final model for: PTB (OR=1.77, p<0.001), LBW (OR=1.67, p<0.001), and IGR (OR=2.06, p<0.001). When the interaction between periodontitis and previous preterm birth were tested, an odds ratio of 5.94 (p<0.001), 9.12 (p<0.001), and 18.90 (p<0.001) for PTB, LBW, and IGR, respectively, were observed. Conclusions: Maternal periodontitis was determined to be associated with an incresead risk for PTB, LBW, and IGR. Results emphasize the importance of periodontal care on prenatal health programs.