Jeffcoat M K, Geurs N C, Reddy M S, Cliver S P, Goldenberg R L, Hauth J C
Department of Periodontics, University of Alabama School of Dentistry, Birmingham 35294, USA.
J Am Dent Assoc. 2001 Jul;132(7):875-80. doi: 10.14219/jada.archive.2001.0299.
Previous studies have suggested that chronic periodontal infection may be associated with preterm births. The authors conducted a prospective study to test for this association.
A total of 1,313 pregnant women were recruited from the Perinatal Emphasis Research Center at the University of Alabama at Birmingham. Complete periodontal, medical and behavioral assessments were made between 21 and 24 weeks gestation. After delivery, medical records were consulted to determine each infant's gestational age at birth. From these data, the authors calculated relationships between periodontal disease and preterm birth, while adjusting for smoking, parity (the state or fact of having born offspring), race and maternal age. Results were expressed as odds ratios and 95 percent confidence intervals, or CIs.
Patients with severe or generalized periodontal disease had adjusted odds ratios (95 percent CI) of 4.45 (2.16-9.18) for preterm delivery (that is, before 37 weeks gestational age). The adjusted odds ratio increased with increasing prematurity to 5.28 (2.05-13.60) before 35 weeks' gestational age and to 7.07 (1.70-27.4) before 32 weeks' gestational age.
The authors' data show an association between the presence of periodontitis at 21 to 24 weeks' gestation and subsequent preterm birth. Further studies are needed to determine whether periodontitis is the cause.
While this large prospective study has shown a significant association between preterm birth and periodontitis at 21 to 24 weeks' gestation, neither it nor other studies to date were designed to determine whether treatment of periodontitis will reduce the risk of preterm birth. Pending an answer to this important question, it remains appropriate to advise expectant mothers about the importance of good oral health.
先前的研究表明，慢性牙周感染可能与早产有关。作者进行了一项前瞻性研究以验证这种关联。
从阿拉巴马大学伯明翰分校围产期重点研究中心招募了1313名孕妇。在妊娠21至24周期间进行了全面的牙周、医学和行为评估。分娩后，查阅医疗记录以确定每个婴儿的出生孕周。根据这些数据，作者计算了牙周疾病与早产之间的关系，同时对吸烟、产次（生育过子女的状况或事实）、种族和产妇年龄进行了校正。结果以比值比和95%置信区间（CI）表示。
患有重度或广泛性牙周疾病的患者早产（即妊娠37周前）的校正比值比（95%CI）为4.45（2.16 - 9.18）。随着早产程度增加，妊娠35周前校正比值比增至5.28（2.05 - 13.60），妊娠32周前增至7.07（1.70 - 27.4）。
作者的数据表明，妊娠21至24周时牙周炎的存在与随后的早产之间存在关联。需要进一步研究以确定牙周炎是否为病因。
虽然这项大型前瞻性研究表明妊娠21至24周时早产与牙周炎之间存在显著关联，但该研究及迄今为止的其他研究均未设计用于确定牙周炎治疗是否会降低早产风险。在这个重要问题得到答案之前，建议准妈妈保持良好口腔健康的重要性仍然是合适的。
