School of Public Health, Fudan University, Shanghai, China.
Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.
BJOG. 2016 Sep;123 Suppl 3:39-47. doi: 10.1111/1471-0528.14010.
To determine whether an antimicrobial mouthrinse intervention reduces adverse pregnancy outcomes in a low-resource rural area.
Randomised controlled trial.
A county-level maternal health care hospital in China.
Pregnant women of less than 20 weeks of gestation having periodontal disease.
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.
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).
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).
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.
Use of antiseptic mouthrinse during pregnancy may improve maternal oral health and pregnancy outcomes.
在资源匮乏的农村地区，确定使用抗菌漱口水干预是否会减少不良妊娠结局。
随机对照试验。
中国一家县级妇幼保健院。
妊娠不足 20 周且患有牙周病的孕妇。
将患有牙周病的孕妇随机分为干预组（n=232）和对照组（n=234）。干预组的参与者可全程免费使用含 0.7%西吡氯铵的无酒精漱口水，并接受口腔卫生教育。对照组仅接受口腔卫生教育。所有参与者在孕晚期均进行牙周复查，并随访至分娩。
主要结局为孕龄。次要结局包括出生体重、牙周病评分、妊娠并发症（小于胎龄儿、妊娠期高血压、妊娠期糖尿病、严重贫血、胎膜早破）。
干预组孕妇在孕晚期的一般牙周状况明显优于对照组（牙周病评分：11.26±3.60 对 11.92±3.01；P=0.04）。两组的妊娠结局除胎膜早破外无差异。与对照组相比，干预组孕妇胎膜早破的风险显著降低（1.4%对 5.7%，OR=0.23，95%CI 0.07-0.84；P=0.03）。
孕期使用漱口水可改善牙周健康。干预并未改变孕龄，但降低了胎膜早破的发生率。需要进一步研究来探索这种关联的生物学机制。
孕期使用抗菌漱口水可能会改善产妇口腔健康和妊娠结局。
