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Pregnancy · Preterm Birth

Periodontal disease and preterm delivery: a nationwide population-based cohort study of Taiwan

Lee YL, Hu HY, Chou SY, Lin CL, Cheng FS, Yu CY, Chu D

Published February 28, 2022 Scientific Reports, 12(1)
DOI 10.1038/s41598-022-07425-8 PMC PMC8885688

RRM Academy Synopsis

Periodontal disease is linked to higher preterm birth risk in Taiwan

Among first-time mothers in Taiwan, treated periodontal disease was linked to higher preterm birth risk. The retrospective cohort covered 1,745,078 women using national records. About 114 out of 1,000 women treated for periodontal disease in the two years before delivery gave birth preterm. Among women without it, about 106 out of 1,000 did.

Key Findings

  • Preterm birth occurred in 11.38% of women with periodontal disease and 10.56% of women without it (p < 0.001), among 1,745,078 first-time mothers.
  • Preterm birth occurred in 11.66% of women with advanced periodontal disease and 11.31% of women with mild periodontal disease.
  • Adjusted for age, income, and obstetric history, the odds ratio for preterm birth was 1.09 (95% CI 1.07–1.11) with advanced disease and 1.05 (95% CI 1.04–1.06) with mild disease.
  • The highest odds ratios fell in women aged 31 to 35 years: 1.13 (95% CI 1.09–1.17) with advanced disease and 1.09 (95% CI 1.07–1.11) with mild disease.
  • Advanced disease carried significantly higher odds in all four age groups. Mild disease showed no significant increase in women aged 20 to 25 or over 35.

Interpretation

The study is a retrospective cohort built on Taiwan's national insurance claims. It describes an association. The adjusted odds ratios range from 1.05 to 1.09, with women without periodontal disease as the reference at 1. Disease and severity came from diagnosis and treatment codes. The database held no data on education, occupation, body mass index, or smoking. Only first-time mothers aged 20 to 45 were included. The authors suggest that better gum health, before or during a pregnancy, may lower the occurrence of adverse pregnancy outcomes. The cohort compared severity groups and included no group of untreated women with the disease.

RRM Context

Restorative reproductive medicine works from root causes and considers the health of both partners before conception. Periodontal disease is a chronic inflammatory condition. This national cohort adds oral health to the list of maternal factors linked with preterm delivery. The finding fits a preconception view of pregnancy health that includes the whole body.

Our editorial summary of this paper, not the article's abstract.

Abstract

Preterm delivery of low-birth weight infants is considered a leading cause of morbidity and mortality among neonates. Various studies have reported a positive correlation between periodontal disease (PD) and premature birth (PB) and yet no population-based study has assessed the impact of PD severity and treatments on premature birth. This cohort study used Taiwan's national medical records (1999-2012, included 1,757,774 pregnant women) to investigate the association between PD severity and PB. Women with PD during the 2-year period prior for giving birth were more likely to have PB (11.38%) than those without PD (10.56%; p < 0.001). After variables adjustment, the advanced PD group had OR of 1.09 (95% CI 1.07-1.11) for PB, the mild PD group had OR of 1.05 (95% CI 1.04-1.06), while no-PD group had OR of 1. Increased PD severity was related to higher risk of PB. When stratified by age, the highest ORs for PB were those aged from 31 to 35 years in both mild PD group (OR = 1.09, 95% CI 1.07-1.11) and advanced PD group (OR = 1.13, 95% CI 1.09-1.17). Improving periodontal health before or during pregnancy may prevent or reduce the occurrence of adverse pregnancy outcomes and therefore maternal and perinatal morbidity and mortality.

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By this author

Related research

Pregnancy › Preterm Birth › Infection and Inflammation · Birth and Delivery › Birth Outcomes › Maternal Morbidity
Ya-Ling Lee, Hsiao-Yun Hu, Sin-Yi Chou, Chen-Li Lin, Feng-Shiang Cheng, Chia-Yi Yu, Dachen Chu
Y Lee, H Hu, S Chou, C Lin, F Cheng, C Yu, D Chu
DOI 10.1038/s41598-022-07425-8 10.1038/s41598-022-07425-8 Lee et al. 2022, Lee 2022

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