Periodontitis Before Pregnancy Increases the Risk for Adverse Pregnancy Outcome

Objectives: Preterm birth is the major cause for neonatal morbidity and mortality. This prospective study examines whether periodontitis before pregnancy increases the risk for pregnancy loss. Methods: Altogether 239 women (mean age 29.2, SD 5.1 yrs) planning for pregnancy were enrolled. Oral examination included periodontal and cariological status. Routine gynecological examination and Gram-stain for bacterial vaginosis (BV) were done. Results: In all 67/239 (28%) women discontinued the study, 37/239 (15%) did not conceive within one year, and 16/239 (7%) are still continuing the study but have not conceived yet. Altogether 119/172 (69%) conceived, 84 (71%) of them gave fullterm birth, 7 (6%) preterm birth (£37 weeks), 14 (12%) had miscarriage, and 14 (12%) are still pregnant. Data from 21 women with pregnancy complications  (7 preterm birth, 14 miscarriage) were compared to those 84 women giving fullterm birth. Deepened (>3mm) periodontal pockets were significantly (P<0.04) more common before pregnancy in women with pregnancy loss (9/21, 43%) as compared to women giving fullterm birth (16/84, 19%). Probing attachment loss (³1 mm) occurred significantly (P<0.004) more often in women with pregnancy loss (6/21, 33% vs. 6/84, 7%). The mean (SD) proportions of tooth sites with deepened pockets (P<0.017) and attachment loss (P<0.002) were higher in women with pregnancy loss (2.1% (4.0) and 1.1% (2.5), resp.) than in women giving fullterm birth (0.6% (1.6) and 0.2% (1.1), resp.). No significant differences were found in age, education, systemic health, medication, frequency of yearly acute infections, oral hygiene habits, previous preterm birth, miscarriage or delivery between these groups. The association between periodontitis and pregnancy loss remained highly significant after multivariate logistic regression analysis, adjusted for these variables and BV status (OR 11.7, 95% Cl 2.2-63.6, P=0.005). Conclusions: The results suggest that periodontitis, even in mild form, is an independent risk factor for adverse pregnancy outcome.