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Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis

Objective To examine whether treatment of periodontal disease with scaling and root planing during pregnancy is associated with a reduction in the preterm birth rate. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Cochrane Central Trials Registry, ISI Web of...

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Autores principales: Polyzos, Nikolaos P, Polyzos, Ilias P, Zavos, Apostolos, Valachis, Antonis, Mauri, Davide, Papanikolaou, Evangelos G, Tzioras, Spyridon, Weber, Daniel, Messinis, Ioannis E
Formato: Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3011371/
https://www.ncbi.nlm.nih.gov/pubmed/21190966
http://dx.doi.org/10.1136/bmj.c7017
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author Polyzos, Nikolaos P
Polyzos, Ilias P
Zavos, Apostolos
Valachis, Antonis
Mauri, Davide
Papanikolaou, Evangelos G
Tzioras, Spyridon
Weber, Daniel
Messinis, Ioannis E
author_facet Polyzos, Nikolaos P
Polyzos, Ilias P
Zavos, Apostolos
Valachis, Antonis
Mauri, Davide
Papanikolaou, Evangelos G
Tzioras, Spyridon
Weber, Daniel
Messinis, Ioannis E
author_sort Polyzos, Nikolaos P
collection PubMed
description Objective To examine whether treatment of periodontal disease with scaling and root planing during pregnancy is associated with a reduction in the preterm birth rate. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Cochrane Central Trials Registry, ISI Web of Science, Medline, and reference lists of relevant studies to July 2010; hand searches in key journals. Study selection Randomised controlled trials including pregnant women with documented periodontal disease randomised to either treatment with scaling and root planing or no treatment. Data extraction Data were extracted by two independent investigators, and a consensus was reached with the involvement a third. Methodological quality of the studies was assessed with the Cochrane’s risk of bias tool, and trials were considered either high or low quality. The primary outcome was preterm birth (<37 weeks). Secondary outcomes were low birthweight infants (<2500 g), spontaneous abortions/stillbirths, and overall adverse pregnancy outcome (preterm birth <37 weeks and spontaneous abortions/stillbirths). Results 11 trials (with 6558 women) were included. Five trials were considered to be of high methodological quality (low risk of bias), whereas the rest were low quality (high or unclear risk of bias). Results among low and high quality trials were consistently diverse; low quality trials supported a beneficial effect of treatment, and high quality trials provided clear evidence that no such effect exists. Among high quality studies, treatment had no significant effect on the overall rate of preterm birth (odds ratio 1.15, 95% confidence interval 0.95 to 1.40; P=0.15). Furthermore, treatment did not reduce the rate of low birthweight infants (odds ratio 1.07, 0.85 to 1.36; P=0.55), spontaneous abortions/stillbirths (0.79, 0.51 to 1.22; P=0.28), or overall adverse pregnancy outcome (preterm births <37 weeks and spontaneous abortions/stillbirths) (1.09, 0.91 to 1.30; P=0.34). Conclusion Treatment of periodontal disease with scaling and root planing cannot be considered to be an efficient way of reducing the incidence of preterm birth. Women may be advised to have periodical dental examinations during pregnancy to test their dental status and may have treatment for periodontal disease. However, they should be told that such treatment during pregnancy is unlikely to reduce the risk of preterm birth or low birthweight infants.
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spelling pubmed-30113712011-01-05 Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis Polyzos, Nikolaos P Polyzos, Ilias P Zavos, Apostolos Valachis, Antonis Mauri, Davide Papanikolaou, Evangelos G Tzioras, Spyridon Weber, Daniel Messinis, Ioannis E BMJ Research Objective To examine whether treatment of periodontal disease with scaling and root planing during pregnancy is associated with a reduction in the preterm birth rate. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Cochrane Central Trials Registry, ISI Web of Science, Medline, and reference lists of relevant studies to July 2010; hand searches in key journals. Study selection Randomised controlled trials including pregnant women with documented periodontal disease randomised to either treatment with scaling and root planing or no treatment. Data extraction Data were extracted by two independent investigators, and a consensus was reached with the involvement a third. Methodological quality of the studies was assessed with the Cochrane’s risk of bias tool, and trials were considered either high or low quality. The primary outcome was preterm birth (<37 weeks). Secondary outcomes were low birthweight infants (<2500 g), spontaneous abortions/stillbirths, and overall adverse pregnancy outcome (preterm birth <37 weeks and spontaneous abortions/stillbirths). Results 11 trials (with 6558 women) were included. Five trials were considered to be of high methodological quality (low risk of bias), whereas the rest were low quality (high or unclear risk of bias). Results among low and high quality trials were consistently diverse; low quality trials supported a beneficial effect of treatment, and high quality trials provided clear evidence that no such effect exists. Among high quality studies, treatment had no significant effect on the overall rate of preterm birth (odds ratio 1.15, 95% confidence interval 0.95 to 1.40; P=0.15). Furthermore, treatment did not reduce the rate of low birthweight infants (odds ratio 1.07, 0.85 to 1.36; P=0.55), spontaneous abortions/stillbirths (0.79, 0.51 to 1.22; P=0.28), or overall adverse pregnancy outcome (preterm births <37 weeks and spontaneous abortions/stillbirths) (1.09, 0.91 to 1.30; P=0.34). Conclusion Treatment of periodontal disease with scaling and root planing cannot be considered to be an efficient way of reducing the incidence of preterm birth. Women may be advised to have periodical dental examinations during pregnancy to test their dental status and may have treatment for periodontal disease. However, they should be told that such treatment during pregnancy is unlikely to reduce the risk of preterm birth or low birthweight infants. BMJ Publishing Group Ltd. 2010-12-29 /pmc/articles/PMC3011371/ /pubmed/21190966 http://dx.doi.org/10.1136/bmj.c7017 Text en © Polyzos et al 2010 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
spellingShingle Research
Polyzos, Nikolaos P
Polyzos, Ilias P
Zavos, Apostolos
Valachis, Antonis
Mauri, Davide
Papanikolaou, Evangelos G
Tzioras, Spyridon
Weber, Daniel
Messinis, Ioannis E
Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis
title Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis
title_full Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis
title_fullStr Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis
title_full_unstemmed Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis
title_short Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis
title_sort obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3011371/
https://www.ncbi.nlm.nih.gov/pubmed/21190966
http://dx.doi.org/10.1136/bmj.c7017
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