Maternal dental caries and pre-term birth: Results from the EPIPAP study

Abstract

Objective. The aim of this study was to analyse the association between maternal dental caries and pre-term birth (PTB), with a particular focus on the infection-suspected causes of pre-term births. Materials and methods. A secondary analysis was performed on data from the EPIPAP study, a French multi-centre case-control study. Cases were 1107 women giving birth to a singleton live-born infant before 37 weeks of gestation and controls were 1094 women delivering at 37 weeks or more. A sub-group of cases was defined as women with spontaneous labour and/or pre-term premature rupture of membranes (PPROM, n = 620). A full-mouth dental examination was performed after delivery. The main factor of interest was the presence of decay on at least one tooth. Results. Crude associations between presence of tooth decay and PTB or spontaneous PTB/PPROM were significant (OR = 1.21 [1.01–1.45] and OR = 1.25 [1.01–1.55], respectively). After adjustment for two sets of potential confounders (four pre-term birth risk factors and four social characteristics), for periodontitis status and for inter-examiner variability, tooth decay was not significantly associated with either PTB or spontaneous PTB/PPROM (aOR = 1.10 [0.91–1.32] and aOR = 1.14 [0.91–1.42], respectively). Conclusions. This study failed to demonstrate a significant association between tooth decay and pre-term birth. However, future well-designed studies are needed to further assess the link between dental caries and adverse pregnancy outcomes.

Key Words::

• Dental caries
• dental decay
• epidemiology
• pregnancy
• premature birth

Acknowledgements

The authors would like to thank Pierre-Yves Ancel, François Goffinet and Laetitia Marchand-Martin for stimulating discussions and helpful assistance. This study was supported by the National Programme for Hospital Clinical Research (national PHRC2004, AOM04047) and INSERM (National Institute of Health and Medical Research).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.