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Gum Disease Again Tied to Pregnancy Outcomes : Women with periodontal disease had higher rates of low-birth-weight babies, preterm births in a small study.


 

LOS ANGELES — A small study adds to the growing body of evidence implicating periodontal disease in poor pregnancy outcomes.

Twelve percent of women with periodontal disease had low-birth-weight babies in a 277-patient observational study. In comparison, only 2% of women with healthy gums had small babies, a statistically significant difference.

The data were presented in poster form at the annual meeting of the Society for Gynecologic Investigation.

The women with periodontal disease also had a higher incidence of preterm births (7% vs. 3%) but Alexis L. Shub, M.D., an investigator in the study, said this difference was not statistically significant. About 15% of women in the study had periodontal disease.

An updated analysis completed just before the meeting also found higher rates of tumor necrosis factor-α in the cord blood of women with periodontal disease, Dr. Shub, an obstetrician at the University of Western Australia in Perth, said in an interview.

These data were not included in the poster presentation, she noted, adding that the findings suggest an ongoing inflammatory process in these women and their fetuses.

John P. Newnham, M.D., who is the study's lead author and director of the Women and Infants Research Foundation at King Edward Memorial Hospital in Perth, said in an interview that he is also working on a large, randomized controlled trial to study this issue. The investigators have begun to divide 1,000 pregnant women with periodontal disease into two cohorts: one given periodontal care during pregnancy and the other afterward. The trial's primary outcomes will be preterm birth, fetal growth, and preeclampsia.

He said the investigators are concerned that heightened awareness of possible harm from periodontal disease could skew outcomes. They suspect screening patients for periodontal disease in the observational study led to better dental care. The preterm birth rates were expected to be about 11%, according to Dr. Newnham, who also plans to monitor pregnancy outcomes and prenatal care in a region-wide medical database.

“The exciting thing is that it is possible that a simple community-based public health intervention could have a profound impact on the need for expensive high-tech hospital resources,” he said.

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