Use of antiseptic mouthrinse during pregnancy and pregnancy outcomes: a randomised controlled clinical trial in rural China.

OBJECTIVE

To determine whether an antimicrobial mouthrinse intervention reduces adverse pregnancy outcomes in a low-resource rural area.

DESIGN

Randomised controlled trial.

SETTING

A county-level maternal health care hospital in China.

SAMPLE

Pregnant women of less than 20 weeks of gestation having periodontal disease.

METHODS

Women with periodontal disease were randomised into the intervention (n = 232) and control group (n = 234). Participants in the intervention group were provided with free mouthrinse (alcohol-free mouthrinse containing 0.7% cetylpyridinium chloride) throughout the pregnancy and given education on oral health. Women in the control group only received oral hygiene education. All participants had a periodontal re-examination at the third trimester and were followed-up to childbirth.

MAIN OUTCOME MEASURES

The primary outcome was gestational age. Secondary outcomes included birthweight, periodontal disease score, pregnancy complications (small-for-gestational-age, gestational hypertension, gestational diabetic mellitus, severe anaemia, premature rupture of membrane).

RESULTS

The general periodontal status of the intervention group at the third trimester was significantly better than that of the control group (measured by periodontal disease score: 11.26 ± 3.60 versus 11.92 ± 3.01; P = 0.04). There was no difference in pregnancy outcome between the two groups except for premature rupture of the membranes. The women in the intervention group had a significantly reduced risk of premature rupture of the membranes compared with the control group (1.4 versus 5.7%, OR = 0.23, 95% CI 0.07-0.84; P = 0.03).

CONCLUSIONS

The mouthrinse intervention during pregnancy improved periodontal health. The intervention did not lead to a change in gestational age but it reduced the rate of premature membrane rupture. Further studies are needed to explore the biological mechanism of this association.

TWEETABLE ABSTRACT

Use of antiseptic mouthrinse during pregnancy may improve maternal oral health and pregnancy outcomes.