The East London study of periodontal disease and preterm low birthweight
Establishment of risk factors, and mechanisms involved in preterm (premature)
birth is important for society. Despite efforts to find the cause(s), a significant
proportion of preterm birth is of unknown aetiology. Maternal infection has been
implicated and oral infection in the form of periodontal (gum) disease has also
been suggested as a risk factor for preterm birth (Offenbacher et ai, 1996).
The aim of this study was to examine the possible relationship between
maternal periodontal disease and the delivery of preterm infants with associated
low birthweight in East London.
This was an unmatched case-control study with 187 cases (mothers whose
infant weighed < 2500g, gestational age < 37 weeks (preterm low birthwieght
(PLBW)), and 532 controls (mothers whose infant weighed 2= 2500g, gestational
age 2= 37 weeks). Risk factor information for prematurity and low birthweight
were collected from Maternity notes and a structured questionnaire. Maternal
periodontal disease levels were measured by: Community Periodontal Index,
periodontal probing pocket depths and a bleeding index. Analysis was by
The study population was derived from a multiethnic inner city population the
predominant groups being Bangladeshi (51.90/0) and white Caucasian (25.9%).
No differences were found between the periodontal status of the case and
control mothers for any of the periodontal indices. The risk for PLBW decreased
significantly (p=0.02) with increasing mean periodontal probing pocket depth
(crude OR 0.83[950/0 Cl 0.68, 1.00]). After controlling for pre-pregnancy
hypertension, smoking, alcohol consumption, maternal age, ethnic group and
mother's education this risk decreased further (OR 0.78[95% Cl 0.63, 0.96]).
No evidence was found for increased risk of PLBW with maternal periodontal
disease as measured in this study population. Promotion of oral health by
healthcare workers is important, but these results did not support a specific
drive to improve the periodontal health of pregnant women as a means of
decreasing adverse pregnancy outcomes.