Division of Neonatology, Department of Pediatrics, University of Texas Health Science Center, San Antonio, Texas 78229, USA.
Am J Perinatol. 2012 Nov;29(10):815-21. doi: 10.1055/s-0032-1316449. Epub 2012 Jul 6.
To determine if antenatal treatment of maternal periodontitis affects early childhood neurodevelopment.
We evaluated neurodevelopment of 331 24-month-old children born to women who participated in a randomized trial of antenatal (167) or postpartum (164) treatment of periodontitis. Children within groups defined by maternal treatment were designated as high risk for abnormal neurodevelopment (n = 96; birth at ≤34(6)/7 weeks' gestation or small for gestational age following birth at term) or low risk (n = 235; appropriate birth weight and ≥37 weeks' gestation). We measured neurodevelopment using the Bayley Scale of Infant and Toddler Development III (BSID III) and neurological examination. Treatment effect was analyzed using a chi-square or Fisher exact test. Between-group mean scores were compared using Student t test.
There were no differences in the incidence of neuromotor or sensory (visual or hearing) impairment or scores on the BSID III between groups. Low-risk children in the antenatal treatment group had higher language scores than those in the postpartum treatment group (92.9 versus 89.2; p = 0.05).
Antenatal treatment of maternal periodontitis does not appear to affect neurodevelopment at 24 months of age. The slight improvement in language development in low-risk children may be an artifact or not clinically relevant.
确定母体牙周炎的产前治疗是否会影响幼儿的神经发育。
我们评估了 331 名 24 个月大的儿童的神经发育情况，这些儿童的母亲参加了一项关于产前（167 名）或产后（164 名）牙周炎治疗的随机试验。根据母亲治疗情况将各组内的儿童定义为神经发育异常的高风险（n=96；出生时胎龄≤34（6）/7 周或足月出生后为小于胎龄儿）或低风险（n=235；出生体重适当且胎龄≥37 周）。我们使用贝利婴幼儿发育量表第三版（BSID III）和神经检查来测量神经发育。采用卡方检验或 Fisher 确切概率法分析治疗效果。采用 Student t 检验比较组间平均得分。
各组之间的运动或感觉神经（视觉或听觉）损伤发生率或 BSID III 评分无差异。产前治疗组的低风险儿童的语言评分高于产后治疗组（92.9 比 89.2；p=0.05）。
母体牙周炎的产前治疗似乎不会影响 24 个月时的神经发育。低风险儿童的语言发育略有改善可能是一种假象，或者没有临床意义。
