DIFFERENTIAL IMPACT OF PERIODONTAL TREATMENT STRATEGIES DURING PREGNANCY ON PERINATAL OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Quynh-Anh Le; Guy D Eslick; Kimberly Mathieu Coulton; Rahena Akhter; Samantha Lain; Natasha Nassar; Albert Yaacoub; George Condous; Mathew Leonardi; Jörg Eberhard; Ralph Nanan

doi:10.1016/j.jebdp.2021.101666

DIFFERENTIAL IMPACT OF PERIODONTAL TREATMENT STRATEGIES DURING PREGNANCY ON PERINATAL OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS

J Evid Based Dent Pract. 2022 Mar;22(1):101666. doi: 10.1016/j.jebdp.2021.101666. Epub 2021 Nov 12.

Authors

Affiliations

¹ School of Dentistry and the Charles Perkins Center, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; School of Odonto-Stomatology, Hanoi Medical University, Hanoi, Vietnam. Electronic address: Qule7436@uni.sydney.edu.au.
² The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, New South Wales, Australia.
³ School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁴ Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.
⁵ Nepean Centre for Oral Health, Nepean Hospital, Kingswood, New South Wales, Australia.
⁶ Acute Gynecology, Early Pregnancy and Advanced Endoscopy Surgery Unit, Nepean Hospital, Sydney Medical School Nepean, The University of Sydney, Sydney, Australia.
⁷ Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada.
⁸ School of Dentistry and The Charles Perkin Center, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁹ Sydney Medical School Nepean and Charles Perkins Center Nepean, The University of Sydney, Sydney, New South Wales, Australia.

PMID: 35219458
DOI: 10.1016/j.jebdp.2021.101666

Abstract

Objectives: This study aimed to evaluate the impact of different periodontal treatment strategies during pregnancy on perinatal outcomes.

Study selection: This systematic review and meta-analysis of clinical trials was conducted according to PRISMA guidelines to assess the effect of mouthwash in addition to scaling and root planning (SRPM) on pregnancy outcomes, including preterm birth, low birth weight, gestational age, and birth weight. Pooled risk ratios (RR), mean differences (MD), and 95% confidence intervals (CI) were calculated using the random effect model.

Results: Twenty trials involving 5938 participants, including thirteen trials comparing scaling and root planning (SRP) and seven trials comparing SRPM with control groups. SRPM was associated with reduced risk of preterm birth (RR = 0.37; 95%CI = 0.16-0.84; P = .017; I²=93.26%; P < .001; number needed to treat (NNT): 3), low birth weight (RR = 0.54; 95%CI = 0.40-0.74; P < .0001; I² = 0%; P = .46; NNT: 13), increased gestational age (MD = 0.78; 95%CI: 0.19-1.37; P = .009; I² = 87.15%; P < .001), and birth weight (MD = 121.77; 95%CI = 3.19-240.34; P = .044; I² = 80.68%; P < .001). There were no statistically significant differences in the analysis of SRP group, except for the increased birth weight (MD = 93.85; 95% CI = 3.27-184.42; P = .042; I² = 84.11%; P < .001).

Conclusion: Using mouthwash in addition to scaling and root planning (SRPM) for the treatment of periodontal disease during pregnancy significantly improves perinatal outcomes.

Keywords: Birthweight; Mouthwash; Periodontitis; Preterm; Scaling and root planning.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Female
Gestational Age
Humans
Infant, Low Birth Weight
Infant, Newborn
Periodontal Diseases* / prevention & control
Pregnancy
Pregnancy Outcome
Premature Birth* / prevention & control