Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112-2715, USA.
Am J Obstet Gynecol. 2011 Aug;205(2):111.e1-6. doi: 10.1016/j.ajog.2011.03.017. Epub 2011 Mar 16.
Several large randomized controlled clinical trials failed to find that standard periodontal therapy during pregnancy reduces the incidence of adverse pregnancy outcomes (eg, preterm birth and low birthweight). However, treating periodontal disease during pregnancy may be too late to reduce the inflammation that is related to the adverse pregnancy outcomes. Moreover, periodontal treatment during pregnancy can cause bacteremia, which itself may initiate the pathway leading to the adverse pregnancy outcomes. Finally, the periodontal treatments provided during pregnancy are not always effective in preventing the progression of periodontal disease during pregnancy. Pregnancy may not be an appropriate period for periodontal intervention(s). We hypothesize that periodontal treatment before pregnancy may reduce the rates of adverse pregnancy outcomes. Future randomized controlled trials are needed to test if treating periodontal disease in the prepregnancy period reduces the rate of adverse pregnancy outcomes.
几项大型随机对照临床试验未能发现妊娠期进行标准牙周治疗可降低不良妊娠结局（如早产和低出生体重）的发生率。然而，在妊娠期治疗牙周病可能为时已晚，无法减轻与不良妊娠结局相关的炎症。此外，妊娠期牙周治疗可引起菌血症，而菌血症本身可能启动导致不良妊娠结局的途径。最后，妊娠期提供的牙周治疗并不总是能有效预防妊娠期牙周病的进展。妊娠期可能不是进行牙周干预的合适时期。我们假设，在妊娠前进行牙周治疗可能会降低不良妊娠结局的发生率。需要开展未来的随机对照试验来检验在妊娠前治疗牙周病是否能降低不良妊娠结局的发生率。
