Periodontal Diseases and Preterm Low Birth Weight in Madagascar

Methods: A cohort study with 204 pregnant women (mean age 25.6 years) was conducted in public prenatal care health clinics at Madagascar. Socio-economic and obstetric information was obtained. Periodontal parameters, such as plaque index (PI), papillary bleeding index (PBI), pocket depth, and clinical attachment level were recorded and analysed.

Results: The mean gestational age was 37.8 weeks. At delivery, 33 newborns (16.2%) displayed only preterm (<37 weeks) birth (PB), 13 (6.4%) only low birth weight (LBW). 9 (4.4%) newborns were PB and LBW (PLBW) and 149 (73%) were non-PB and non-LBW (NPLBW). Socio-economic and obstetric characteristics did not significantly differ between these groups. Mean PI and PBI were significantly higher (p<0.05 and p<0.001) in PB group than in NPLBW group. Periodontitis (at least 3 sites from different teeth with a clinical attachment loss over 4mm) was significantly associated to PB (p<0.001), LBW (p<0.001), and PLBW (p<0.01) groups. The percentages of periodontitis in PB (79%), in LBW (77%), and in PLBW (78%) groups were considerably higher than in NPLBW (3%) group.

Conclusions: The relative high percentage of PB and LBW observed in this non-smoker population of pregnant women in Madagascar and the relative homogeneity of socio-economic and obstetric data between subgroups suggest the existence of another risk factor. The strong association between periodontitis and adverse pregnancy outcomes observed in this study highlighted the influence of periodontal status and the interest of periodontal care for pregnant women in Madagascar.