Offenbacher Steven, Boggess Kim A, Murtha Amy P, Jared Heather L, Lieff Susan, McKaig Rosemary G, Mauriello Sally M, Moss Kevin L, Beck James D
Department of Periodontology, Center for Oral and Systemic Diseases, University of North Carolina School of Dentistry, Chapel Hill, North Carolina 27599-7455, USA.
Obstet Gynecol. 2006 Jan;107(1):29-36. doi: 10.1097/01.AOG.0000190212.87012.96.
The goal was to estimate whether maternal periodontal disease was predictive of preterm (less than 37 weeks) or very preterm (less than 32 weeks) births.
A prospective study of obstetric outcomes, entitled Oral Conditions and Pregnancy (OCAP), was conducted with 1,020 pregnant women who received both an antepartum and postpartum periodontal examination. Predictive models were developed to estimate whether maternal exposure to either periodontal disease at enrollment (less than 26 weeks) and/or periodontal disease progression during pregnancy, as determined by comparing postpartum with antepartum status, were predictive of preterm or very preterm births, adjusting for risk factors including previous preterm delivery, race, smoking, social domain variables, and other infections.
Incidence of preterm birth was 11.2% among periodontally healthy women, compared with 28.6% in women with moderate-severe periodontal disease (adjusted risk ratio [RR] 1.6, 95% confidence interval [CI] 1.1-2.3). Antepartum moderate-severe periodontal disease was associated with an increased incidence of spontaneous preterm births (15.2% versus 24.9%, adjusted RR 2.0, 95% CI 1.2-3.2). Similarly, the unadjusted rate of very preterm delivery was 6.4% among women with periodontal disease progression, significantly higher than the 1.8% rate among women without disease progression (adjusted RR 2.4, 95% CI 1.1-5.2).
The OCAP study demonstrates that maternal periodontal disease increases relative risk for preterm or spontaneous preterm births. Furthermore, periodontal disease progression during pregnancy was a predictor of the more severe adverse pregnancy outcome of very preterm birth, independently of traditional obstetric, periodontal, and social domain risk factors.
II-2.
评估孕妇牙周疾病是否可预测早产（小于37周）或极早产（小于32周）。
开展一项名为“口腔状况与妊娠（OCAP）”的产科结局前瞻性研究，对1020名孕妇进行了产前和产后牙周检查。建立预测模型，以评估孕妇在入组时（小于26周）暴露于牙周疾病和/或孕期牙周疾病进展（通过比较产后与产前状况确定）是否可预测早产或极早产，并对包括既往早产、种族、吸烟、社会领域变量及其他感染等危险因素进行校正。
牙周健康的女性早产发生率为11.2%，中度至重度牙周疾病的女性为28.6%（校正风险比[RR]1.6，95%置信区间[CI]1.1 - 2.3）。产前中度至重度牙周疾病与自发性早产发生率增加相关（15.2%对24.9%，校正RR 2.0，95% CI 1.2 - 3.2）。同样，牙周疾病进展的女性未经校正的极早产发生率为6.4%，显著高于无疾病进展女性的1.8%（校正RR 2.4，95% CI 1.1 - 5.2）。
OCAP研究表明，孕妇牙周疾病会增加早产或自发性早产的相对风险。此外，孕期牙周疾病进展是极早产这一更严重不良妊娠结局的预测因素，独立于传统产科、牙周及社会领域的危险因素。
II - 2。
