Document Type

Article

Publication Date

2024

DOI

10.1186/s12884-024-06905-1

Publication Title

BMC Pregnancy and Childbirth

Volume

24

Pages

726 (1-12)

Abstract

The effect of treating periodontal disease (PD) during pregnancy on adverse birth outcomes, such as preterm birth (PTB) and/or low birth weight (LBW), remains unclear. This is partially due to the fact that Randomized Controlled Trials (RCTs) have used different combinations of treatment approaches to test this hypothesis. In this meta-analysis of RCTs, we assessed the impact of treating PD during pregnancy with scaling and root planning (SRP) and mouthwash use on PTB and LBW.

Background

The effect of treating periodontal disease (PD) during pregnancy on adverse birth outcomes, such as preterm birth (PTB) and/or low birth weight (LBW), remains unclear. This is partially due to the fact that Randomized Controlled Trials (RCTs) have used different combinations of treatment approaches to test this hypothesis. In this meta-analysis of RCTs, we assessed the impact of treating PD during pregnancy with scaling and root planning (SRP) and mouthwash use on PTB and LBW.A systematic review with meta-analysis was conducted following PRISMA guidelines. A comprehensive search strategy was employed across electronic databases, including PubMed/Medline, Embase, and Google Scholar. Quality assessment was performed using the Cochrane Risk of Bias 2 Tool. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using random-effect models.

Methods

A systematic review with meta-analysis was conducted following PRISMA guidelines. A comprehensive search strategy was employed across electronic databases, including PubMed/Medline, Embase, and Google Scholar. Quality assessment was performed using the Cochrane Risk of Bias 2 Tool. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using random-effect models.

Results

Out of 133 initially identified reports, 9 RCTs involving 3,985 pregnant women met the inclusion criteria. Periodontal treatment with SRP and mouthwash use in pregnancy was associated with a lower risk of PTB and LBW in meta-analysis with random effects models (pooled RR for PTB = 0.44, 95% CI: 0.22-0.88) and (pooled RR for LBW = 0.33, 95% CI: 0.13-0.84). Substantial heterogeneity was observed among studies (I2 = 91% and 90% for PTB and LBW, respectively), with sensitivity analysis suggesting potential sources of heterogeneity. Funnel plot assessment for publication bias showed evidence of asymmetry. SRP with mouthwash use during pregnancy were associated with significantly lower risks of PTB and LBW. Larger, well-conducted RCTs are warranted to address this issue, as existing trials are small and exhibit methodological and statistical heterogeneity.

Conclusions

RP with mouthwash use during pregnancy were associated with significantly lower risks of PTB and LBW. Larger, well-conducted RCTs are warranted to address this issue, as existing trials are small and exhibit methodological and statistical heterogeneity.

Rights

© The Authors 2024.

This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if you modified the licensed material. You do not have permission under this license to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

Data Availability

Article states: "Data sharing does not apply to this study, as no datasets were created or analyzed. The papers identified during the literature searches are compiled in an EndNote Library managed by the first author."

Original Publication Citation

Salama, M., Al-Taiar, A., McKinney, D. C., Rahman, E., & Merchant, A. T. (2024). The impact of scaling and root planning combined with mouthwash during pregnancy on preterm birth and low birth weight: A systematic review and meta-analysis. BMC Pregnancy and Childbirth, 24(1), 1-12, Article 726. https://doi.org/10.1186/s12884-024-06905-1

ORCID

0000-0001-7421-3381 (Al-Taiar)

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