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Periodontitis and adverse pregnancy outcomes: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases
Author(s) -
Sanz Mariano,
Kornman Kenneth
Publication year - 2013
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/jcpe.12083
Subject(s) - medicine , periodontitis , pregnancy , miscarriage , obstetrics , population , bleeding on probing , adverse effect , epidemiology , premature birth , disease , low birth weight , intensive care medicine , dentistry , gestation , environmental health , genetics , biology
Abstract Background Pregnancy sometimes has adverse outcomes including low birthweight (<2500 g), pre‐term birth (<37 weeks), growth restriction, pre‐eclampsia, miscarriage and/or stillbirth. Maternal periodontitis directly and/or indirectly have potential to influence the health of the foetal–maternal unit. Aims To assess the epidemiological evidence for the impact of periodontal disease on adverse pregnancy outcomes and to identify potential underpinning mechanisms. Epidemiology Low birthweight, pre‐term birth and pre‐eclampsia have been associated with maternal periodontitis exposure. However, the strength of the observed associations is modest and seems to vary according to the population studied, the means of periodontal assessment and the periodontal disease classification employed. Biological mechanisms Two major pathways have been identified, One direct, in which oral microorganisms and/or their components reach the foetal–placental unit and one indirect, in which Inflammatory mediators circulate and impact the foetal–placental unit. Interventions Although periodontal therapy has been shown to be safe and leads to improved periodontal conditions in pregnant women, case‐related periodontal therapy, with or without systemic antibiotics does not reduce overall rates of pre‐term birth and low birthweight. Guidelines Given the current evidence, various treatment strategies could be evaluated that consider specific target populations, as well as timing and intensity of treatment.