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Meta-Analysis
. 2022 Dec;26(12):2419-2443.
doi: 10.1007/s10995-022-03556-6. Epub 2022 Oct 8.

Periodontitis and Preeclampsia in Pregnancy: A Systematic Review and Meta-Analysis

Quynh-Anh Le  1   2 , Rahena Akhter  3 , Kimberly Mathieu Coulton  3 , Ngoc Truong Nhu Vo  4 , Le Thi Yen Duong  5 , Hoang Viet Nong  5 , Albert Yaacoub  6 , George Condous  7 , Joerg Eberhard  3 , Ralph Nanan  8
Affiliations
Meta-Analysis

Periodontitis and Preeclampsia in Pregnancy: A Systematic Review and Meta-Analysis

Quynh-Anh Le et al. Matern Child Health J. 2022 Dec.

Abstract

Objectives: A conflicting body of evidence suggests localized periodontal inflammation spreads systemically during pregnancy inducing adverse pregnancy outcomes. This systematic review and meta-analysis aim to specifically evaluate the relationship between periodontitis and preeclampsia.

Methods: Electronic searches were carried out in Medline, Pubmed, Embase, Lilacs, Cochrane Controlled Clinical Trial Register, CINAHL, ClinicalTrials.gov, and Google Scholar with no restrictions on the year of publication. We identified and selected observational case-control and cohort studies that analyzed the association between periodontal disease and preeclampsia. This meta-analysis was conducted following the PRISMA checklist and MOOSE checklist. Pooled odds ratios, mean difference, and 95% confidence intervals were calculated using the random effect model. Heterogeneity was tested with Cochran's Q statistic.

Results: Thirty studies including six cohort- and twenty-four case-control studies were selected. Periodontitis was significantly associated with increased risk for preeclampsia (OR 3.18, 95% CI 2.26 - 4.48, p < 0.00001), especially in a subgroup analysis including cohort studies (OR 4.19, 95% CI 2.23 - 7.87, p < 0.00001). The association was even stronger in a subgroup analysis with lower-middle-income countries (OR 6.70, 95% CI 2.61 - 17.19, p < 0.0001).

Conclusions: Periodontitis appears as a significant risk factor for preeclampsia, which might be even more pronounced in lower-middle-income countries. Future studies to investigate if maternal amelioration of periodontitis prevents preeclampsia might be warranted.

Keywords: Hypertension; Periodontal disease; Periodontitis; Pre-eclampsia; Preeclampsia; Pregnancy outcome.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of study selection
Fig. 2
Fig. 2
Forest plot for the association between periodontitis and preeclampsia
Fig. 3
Fig. 3
Forest plot for the subgroup analysis according to the type of study design (cohort study)
Fig. 4
Fig. 4
Forest plot for the subgroup analysis according to the type of study design (case–control study)
Fig. 5
Fig. 5
Forest plot for the subgroup analysis according to the national income (high income countries)
Fig. 6
Fig. 6
Forest plot for the subgroup analysis according to the national income (upper middle-income countries)
Fig. 7
Fig. 7
Forest plot for the subgroup analysis according to the national income (lower middle- income countries)
Fig. 8
Fig. 8
Forest plot for the subgroup analysis according to the definition of periodontitis (PD alone)
Fig. 9
Fig. 9
Forest plot for the subgroup analysis according to the definition of periodontitis (PD and CAL)
Fig. 10
Fig. 10
Forest plot for the subgroup analysis according to the definition of periodontitis (CAL alone)
Fig. 11
Fig. 11
Forest plot for the subgroup analysis of mean CAL between preeclamptic and healthy groups
Fig. 12
Fig. 12
Forest plot for the subgroup analysis of mean PD between preeclamptic and healthy groups
Fig. 13
Fig. 13
Funnel plot for the association between periodontitis and preeclampsia
See this image and copyright information in PMC

Comment in

References

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