Departament of Periodontology, Wrocław Medical University, Poland.
Ginekol Pol. 2020;91(3):158-164. doi: 10.5603/GP.2020.0024.
The aim of the study is to review systematic cohort and randomized trials on the relationship between periodontitis and preeclampsia. Periodontitis is an independent risk factor for preeclampsia (PE), and periodontal treatment could play a significant role in the prevention of this pregnancy complication.
A total of 821 items (published until March 2019), thematically related to the relationship between periodontitis, its treatment and the incidence of preeclampsia, were collected from the databases of PubMed, Scopus, Google Scholar and the Polish Database of Medical Bibliography and analyzed. In the end, 6 cohort studies and 3 randomized controlled trials (from the years 2003-2016) were deemed eligible for the review. The main exclusion criteria were as follows: case-control and cross-sectional studies, medical and dental conditions.
A significant relationship between periodontitis and the risk for developing preeclampsia was demonstrated in 5 cohort trials, which was not confirmed by only 1 study. A total of 2724 pregnant women, including 195 (7.16%) with PE, were analyzed. In 3 randomized trials which assessed the impact of non-surgical treatment (scaling and root planing = SRP) on the occurrence of preeclampsia, the preventive effects of the implemented treatment was not confirmed. A total of 116 women from the group of 1825 pregnant subjects undergoing the non-surgical treatment (SRP) and 116 women from the control group of 1827 pregnant women were subsequently diagnosed with PE, which amounted to 6.30% and 6.35%, respectively.
The cohort studies indicated that periodontitis may result in an increased risk for developing PE. A more detailed analysis regarding the impact of potential risk factors and modification of further studies (clarification of how periodontitis and preeclampsia should be defined in observations, consideration of disease severity, earlier at 12-16 weeks of gestation - implementation of the non-surgical treatment, modification and extension of the classical protocol of the non-surgical treatment of periodontal diseases, as well as conducting European studies), are necessary due to considerable discrepancies in the available literature sources (cohort and randomized observations).
本研究旨在综述牙周炎与子痫前期相关性的系统队列研究和随机试验。牙周炎是子痫前期（PE）的独立危险因素，牙周治疗可能在预防这一妊娠并发症方面发挥重要作用。
从 PubMed、Scopus、Google Scholar 和波兰医学文献数据库中收集了 821 项与牙周炎、其治疗与子痫前期发生率相关的主题相关项目（截至 2019 年 3 月发表），并进行了分析。最终，有 6 项队列研究和 3 项随机对照试验（2003-2016 年）符合综述条件。主要排除标准为病例对照和横断面研究、医疗和牙科状况。
5 项队列研究表明牙周炎与子痫前期风险之间存在显著相关性，而仅有 1 项研究未证实这一相关性。共分析了 2724 名孕妇，其中 195 名（7.16%）患有子痫前期。在 3 项评估非手术治疗（刮治和根面平整=SRP）对子痫前期发生影响的随机试验中，未证实所实施治疗的预防效果。在接受非手术治疗（SRP）的 1825 名孕妇组中，有 116 名孕妇和对照组 1827 名孕妇中，分别有 116 名孕妇随后被诊断为子痫前期，发生率分别为 6.30%和 6.35%。
队列研究表明，牙周炎可能增加发生子痫前期的风险。由于现有文献来源（队列和随机观察）存在较大差异，有必要进行更详细的分析，以确定潜在危险因素的影响，并对进一步的研究进行修正（明确在观察中应如何定义牙周炎和子痫前期，考虑疾病严重程度，在 12-16 周妊娠时更早实施非手术治疗，修正和扩展牙周疾病非手术治疗的经典方案，并开展欧洲研究）。
