Reports

Meta-analysis: Biological mechanisms between periodontal diseases and pregnancy

Report by Dr Morena Petrini, Dr Mervi Gürsoy, Dr Stefano Gennai and Prof Filippo Graziani

A systematic review and meta-analysis of epidemiological association between adverse pregnancy outcomes and periodontitis: an update of the review by Ide & Papapanou (2013)

There is still no clear evidence to support the association between maternal periodontal disease and adverse pregnancy outcomes. Contradictory findings been reported and the available literature is too heterogenous to be able to draw solid and definitive conclusions. Studies of adverse pregnancy outcomes and periodontitis indicate that there might be some association. But the strength of this association is extremely limited and for all the research papers that do indicate association, an equal number of studies do not. There is evidence that adverse pregnancy outcomes are correlated with intra-uterine infections and increased local and systemic inflammatory markers, and a double relationship with periodontitis has been hypothesised. Periodontitis is also a chronic inflammation, caused by the persistence of bacterial infection, and is thus a potential source of circulating inflammatory biomarkers which might be related to possible adverse pregnancy outcomes. Further co-ordinated research is very much needed.

Key points

• There is still no clear evidence to support the association between maternal periodontal disease and adverse pregnancy outcomes.
• Contradictory findings have been reported and the available literature is too heterogenous to be able to draw solid and definitive conclusions.
• Studies of adverse pregnancy outcomes and periodontitis indicate that there might be some association. But the strength of this association is extremely limited – for all the research papers that indicate association, an equal number of studies do not.
• As pregnancy outcomes may be correlated with intra-uterine infections and increased local and systemic inflammatory markers, a double relationship with periodontitis has been hypothesised.
• Periodontitis is a chronic inflammation and is thus a potential source of circulating inflammatory biomarkers that might be related to possible adverse pregnancy outcomes.
• Further co-ordinated research is very much needed.