Association between early preterm birth and periodontitis according to USA and European consensus definitions

Abstract

Objective: Prospective case–control study assessing the association between maternal periodontitis according to the recently issued USA and European consensus definitions and early preterm delivery (<35 weeks gestation). Cases were women delivering between 22 and 34^6/7 weeks of gestation (n = 84) and controls were women delivering at term (≥37 weeks) (n = 345). Methods: Periodontal examination at the immediate postpartum period identified periodontitis according to both consensus definitions. A multivariate logistic model was used to assess the association between early preterm delivery and the presence of periodontitis adjusted for confounders. Results: All women had periodontitis by the European consensus definitions. When using the USA definitions, more cases had severe periodontitis than controls (34.5% vs. 17.72%); p = 0.003. After adjustment for main confounders, the association between severe (OR: 2.38; 95% CI: 1.36–4.14) periodontitis and early preterm delivery persisted. The only other independent factor associated with early preterm delivery was vaginal bleeding during pregnancy. Conclusions: Early preterm delivery is associated with periodontitis when the USA consensus definitions are used. The European definitions revealed inadequate for the study population because of the lack of discrimination power.

Keywords::

• Consensus definitions
• early preterm delivery
• Europe
• periodontal disease
• USA

Acknowledgements

We thank the women delivering at the Department of Gynaecology and Obstetrics, University of Geneva Hospitals, without whom this study could not have been done. We thank also Michel Boulvain, Véronique Othenin-Girard, Rhimou Azbar, and Magalie Tellenbach from the research unit of the obstetrics service, Sylvie Roiron and Vanessa Petitpierre from the School of Dental Health for their collaboration in the implementation of the study, and Rosemary Sudan for editorial assistance.

Declaration of Interest: BMT has received an honorarium for a lecture by Vifor, Amniosure and Tibotec and travel grants from Ferring and Medinova. All other authors declare no conflict of interest. The contributions of individual authors to this paper as follows: planning research (BMT, OI and PB); executing research (BMT, PB); analyzing data (BMT, PB, AGA, CC); interpreting data (BMT, PB, AGA, CC); and writing (all authors). The study was supported by a quality improvement grant from the University Hospitals of Geneva. The study was approved by the Ethics Committee/Institutional Review Board of the University Hospitals of Geneva (study number 07-008, approved March 28 2007) and all women gave written informed consent.