Women’s health centre

Study: Gum disease linked to premature births

15^th September 2010 - US scientists have found a link between the success of gum disease treatment for pregnant women and the chances of them giving birth prematurely.

There’s increasing evidence that oral health can affect other parts of the body. Earlier this month, University of Bristol researchers reported on bacteria found in people who don't brush their teeth properly being linked to an increased risk of heart attacks.

Premature birth

Around one baby in every 10 in the UK will be born before the 37th week of pregnancy.

Risk factors for premature birth include being overweight, alcohol consumption and smoking. Now, researchers say oral infections may also be to blame.

New research

The University of Pennsylvania study looked at 322 pregnant women with gum disease.

The group was split in half. One group was given scaling and root planing - cleaning above and below the gum-line, as well as training on better oral hygiene. The other group only received oral hygiene training.

The number of preterm births was high in both the treatment group and the untreated group.

52.4% of the women in the untreated control group had a preterm baby compared with 45.6% in the treatment group. This wasn’t a big enough difference to prove that the treatment helped.

The researchers then looked at whether there was a difference where the treatment had worked and when it hadn’t.

The women were checked again 20 weeks after the initial oral health treatment. Success was measured by reduced inflammation and no increase in loosening of the teeth.

Within the treatment group of 160 women, the treatment was a success for 49 women. Only four of them had a preterm baby - 8%.

The treatment was unsuccessful for 111 women, however, and 69 of these (62%) had preterm babies.

The researchers say that pregnant women in whom scaling and root planing was unsuccessful were more likely to deliver babies early than those where the treatment worked.

The average age of the women in the study was just under 24. 87.5% were African-American and 90% had not seen a dentist for tooth cleaning.

‘Excited about the results’

Lead author Marjorie Jeffcoat, Professor of Periodontology at the University of Pennsylvania, says in a statement: “Our research group is very excited about these results.  First these data show that pregnant women can receive periodontal treatment safely in order to improve their oral health.” 

Successful dental treatment, alongside normal pregnancy care, she says, “may reduce the incidence of preterm birth”.

The study team is now looking at whether antimicrobial mouth rinses can help reduce preterm births.

Comment

The study is published today in BJOG: An International Journal of Obstetrics and Gynaecology.

In a statement, Professor Philip Steer, BJOG editor-in-chief, sounds a note of caution: “we need to bear in mind that 69% of women failed to respond to the dental treatment given. Therefore more effective treatment will need to be devised before we can be sure that successful treatment improves outcome, rather than simply being a marker of pregnancies with a lower background level of inflammation that will go to term anyway.

“It is important that pregnant women are given advice on dental treatment; however it is also important to note that there are many other causes of preterm birth that should also be tackled, such as smoking, excess alcohol consumption and obesity.”

Sue Macdonald, Education and Research Manager at the Royal College of Midwives, told us by email: “This is an interesting research project that has implications for midwives. One of the areas that midwives advise on is dental care and healthy eating.  

"For some women the first visit to a midwife may be the first time that the woman interacts with a health professional. This provides an important opportunity for the midwife to explain about the importance of good dental care, during and beyond pregnancy.”