Quynh-Anh Le1,2, Rahena Akhter3, Kimberly Mathieu Coulton3, Ngoc Truong Nhu Vo4, Le Thi Yen Duong5, Hoang Viet Nong5, Albert Yaacoub6, George Condous7, Joerg Eberhard3, Ralph Nanan8. 1. School of Dentistry and the Charles Perkins Center, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. Qule7436@uni.sydney.edu.au. 2. School of Odonto-Stomatology, Hanoi Medical University, Hanoi, Vietnam. Qule7436@uni.sydney.edu.au. 3. School of Dentistry and the Charles Perkins Center, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. 4. Department of Pediatric Dentistry, School of Odonto-Stomatology, Hanoi Medical University, Hanoi, Vietnam. 5. School of Odonto-Stomatology, Hanoi Medical University, Hanoi, Vietnam. 6. Nepean Centre for Oral Health, Nepean Hospital, Kingswood, NSW, Australia. 7. Acute Gynaecology, Early Pregnancy, and Advanced Endoscopy Surgery Unit, Sydney Medical School Nepean, Nepean Hospital, University of Sydney, Sydney, Australia. 8. Sydney Medical School Nepean and Charles Perkins Center Nepean, The University of Sydney, Sydney, NSW, Australia.
Abstract
OBJECTIVES: A conflicting body of evidence suggests localized periodontal inflammation spreads systemically during pregnancy inducing adverse pregnancy outcomes. This systematic review and meta-analysis aim to specifically evaluate the relationship between periodontitis and preeclampsia. METHODS: Electronic searches were carried out in Medline, Pubmed, Embase, Lilacs, Cochrane Controlled Clinical Trial Register, CINAHL, ClinicalTrials.gov, and Google Scholar with no restrictions on the year of publication. We identified and selected observational case-control and cohort studies that analyzed the association between periodontal disease and preeclampsia. This meta-analysis was conducted following the PRISMA checklist and MOOSE checklist. Pooled odds ratios, mean difference, and 95% confidence intervals were calculated using the random effect model. Heterogeneity was tested with Cochran's Q statistic. RESULTS: Thirty studies including six cohort- and twenty-four case-control studies were selected. Periodontitis was significantly associated with increased risk for preeclampsia (OR 3.18, 95% CI 2.26 - 4.48, p < 0.00001), especially in a subgroup analysis including cohort studies (OR 4.19, 95% CI 2.23 - 7.87, p < 0.00001). The association was even stronger in a subgroup analysis with lower-middle-income countries (OR 6.70, 95% CI 2.61 - 17.19, p < 0.0001). CONCLUSIONS: Periodontitis appears as a significant risk factor for preeclampsia, which might be even more pronounced in lower-middle-income countries. Future studies to investigate if maternal amelioration of periodontitis prevents preeclampsia might be warranted.
OBJECTIVES: A conflicting body of evidence suggests localized periodontal inflammation spreads systemically during pregnancy inducing adverse pregnancy outcomes. This systematic review and meta-analysis aim to specifically evaluate the relationship between periodontitis and preeclampsia. METHODS: Electronic searches were carried out in Medline, Pubmed, Embase, Lilacs, Cochrane Controlled Clinical Trial Register, CINAHL, ClinicalTrials.gov, and Google Scholar with no restrictions on the year of publication. We identified and selected observational case-control and cohort studies that analyzed the association between periodontal disease and preeclampsia. This meta-analysis was conducted following the PRISMA checklist and MOOSE checklist. Pooled odds ratios, mean difference, and 95% confidence intervals were calculated using the random effect model. Heterogeneity was tested with Cochran's Q statistic. RESULTS: Thirty studies including six cohort- and twenty-four case-control studies were selected. Periodontitis was significantly associated with increased risk for preeclampsia (OR 3.18, 95% CI 2.26 - 4.48, p < 0.00001), especially in a subgroup analysis including cohort studies (OR 4.19, 95% CI 2.23 - 7.87, p < 0.00001). The association was even stronger in a subgroup analysis with lower-middle-income countries (OR 6.70, 95% CI 2.61 - 17.19, p < 0.0001). CONCLUSIONS: Periodontitis appears as a significant risk factor for preeclampsia, which might be even more pronounced in lower-middle-income countries. Future studies to investigate if maternal amelioration of periodontitis prevents preeclampsia might be warranted.
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