牙周治疗对早产率的影响：一项随机对照试验。
Effects of periodontal therapy on rate of preterm delivery: a randomized controlled trial.
作者信息
Offenbacher Steven, Beck James D, Jared Heather L, Mauriello Sally M, Mendoza Luisto C, Couper David J, Stewart Dawn D, Murtha Amy P, Cochran David L, Dudley Donald J, Reddy Michael S, Geurs Nicolaas C, Hauth John C
机构信息
From the Departments of Dental Ecology/Dental Research, Periodontology, and Biostatistics, and the Data and Statistical Coordinating Center, University of North Carolina, Chapel Hill, North Carolina; the Department of Maternal Fetal Medicine, Duke University, Durham, North Carolina; the Departments of Periodontics and Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, Texas; and the Departments of Periodontology and Obstetrics and Gynecology, University of Alabama, Birmingham, Alabama.
出版信息
Obstet Gynecol. 2009 Sep;114(3):551-559. doi: 10.1097/AOG.0b013e3181b1341f.
OBJECTIVE
To test the effects of maternal periodontal disease treatment on the incidence of preterm birth (delivery before 37 weeks of gestation).
METHODS
The Maternal Oral Therapy to Reduce Obstetric Risk Study was a randomized, treatment-masked, controlled clinical trial of pregnant women with periodontal disease who were receiving standard obstetric care. Participants were assigned to either a periodontal treatment arm, consisting of scaling and root planing early in the second trimester, or a delayed treatment arm that provided periodontal care after delivery. Pregnancy and maternal periodontal status were followed to delivery and neonatal outcomes until discharge. The primary outcome (gestational age less than 37 weeks) and the secondary outcome (gestational age less than 35 weeks) were analyzed using a chi test of equality of two proportions.
RESULTS
The study randomized 1,806 patients at three performance sites and completed 1,760 evaluable patients. At baseline, there were no differences comparing the treatment and control arms for any of the periodontal or obstetric measures. The rate of preterm delivery for the treatment group was 13.1% and 11.5% for the control group (P=.316). There were no significant differences when comparing women in the treatment group with those in the control group with regard to the adverse event rate or the major obstetric and neonatal outcomes.
CONCLUSION
Periodontal therapy did not reduce the incidence of preterm delivery.
LEVEL OF EVIDENCE
I.
目的
测试孕期牙周疾病治疗对早产（妊娠37周前分娩）发生率的影响。
方法
“降低产科风险的孕产妇口腔治疗研究”是一项针对接受标准产科护理的牙周疾病孕妇的随机、设盲、对照临床试验。参与者被分配到牙周治疗组，即在孕中期早期进行龈下刮治和根面平整，或延迟治疗组，即在分娩后提供牙周护理。对妊娠和孕产妇牙周状况进行跟踪直至分娩，并对新生儿结局进行跟踪直至出院。使用两个比例相等性的卡方检验分析主要结局（孕周小于37周）和次要结局（孕周小于35周）。
结果
该研究在三个实施地点对1806名患者进行了随机分组，完成了1760名可评估患者的研究。在基线时，治疗组和对照组在任何牙周或产科指标方面均无差异。治疗组的早产率为13.1%，对照组为11.5%（P = 0.316）。在比较治疗组女性与对照组女性的不良事件发生率或主要产科和新生儿结局时，没有显著差异。
结论
牙周治疗并未降低早产发生率。
证据级别
I级
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