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. 2018 Sep 29;18(1):161.
doi: 10.1186/s12903-018-0623-2.

History of periodontal treatment and risk for intrauterine growth restriction (IUGR)

Cande V Ananth  1   2 , Howard F Andrews  3   4 , Panos N Papapanou  5 , Angela M Ward  6 , Emilie Bruzelius  2   6 , Mary Lee Conicella  7 , David A Albert  8
Affiliations

History of periodontal treatment and risk for intrauterine growth restriction (IUGR)

Cande V Ananth et al. BMC Oral Health. .

Abstract

Background: To explore the hypothesis that maternal periodontitis is associated with increased risk for Intrauterine Growth Restriction (IUGR), we examined the risk of IUGR in relation to periodontal treatment before, during and after pregnancy.

Methods: We conducted a retrospective cohort analysis of insurance claims data from 2009 to 2012 for women who delivered a singleton live birth (n = 32,168). IUGR was examined as a function of type and timing of dental treatment, adjusting for potential confounders in logistic regression. Sensitivity analysis evaluated the potential effects of unmeasured confounding.

Results: Women who received periodontal treatment after delivery, indicating the presence of untreated periodontal disease during pregnancy, had significantly higher odds of IUGR compared to women who received no periodontal treatment (adjusted OR 1.5, 95% CI 1.2, 1.8).

Conclusions: Periodontal treatment provided in the immediate postpartum period, a proxy for periodontitis during gestation, was associated with increased risk of IUGR.

Keywords: Fetal inflammatory response; Intrauterine growth restriction; Periodontal treatment.

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Conflict of interest statement

Ethics approval and consent to participate

This study was reviewed by the Columbia University Medical Center, NY, Institutional Review Board and declared exempt (IRB-AAAL5215).

Consent for publication

Not applicable.

Competing interests

CA, DA, PP, HA, EB and AW declare that they do not competing interests on this data analysis and manuscript. MC is an employee of Aetna Inc.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Sensitivity Analysis for Unmeasured Confounding Between Periodontal Treatment Before, During and Post-Gestation and IUGR. Sensitivity analysis to evaluate the impact of unmeasured confounding of the association between periodontal treatment before (top panel), during (middle panel), and post-gestation (bottom panel) and IUGR. The observed confounder-adjusted odds ratio and 95% confidence interval are also shown for each panel. The unmeasured confounding bias-corrected odds ratio of IUGR for each of the three periodontal treatment periods are shown for prevalence estimates varying from 0.5 to 6.0% of the unmeasured confounder among both the IUGR and non-IUGR groups. The odds ratio of IUGR in relation to the unmeasured confounder is assumed to be 1.25. The red circle for each panel shows the bias-corrected odds ratio for one scenario of the prevalence of the unmeasured confounder of 2% and 4% among IUGR and non-IUGR groups, respectively, and the odds ratio of IUGR in relation to the unmeasured confounder of 1.25. The bias-corrected odds ratio for each of the three scenarios are 0.9 (95% CI 0.6, 1.5) for pre-gestation periodontal treatment, 1.6 (95% CI 1.1, 2.3) for periodontal treatment during pregnancy, and 2.0 (95% CI 1.6, 2.3) for periodontal treatment post-gestation
See this image and copyright information in PMC

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