School of Dentistry and the Charles Perkins Center, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
School of Odonto-Stomatology, Hanoi Medical University, Hanoi, Vietnam.
Matern Child Health J. 2022 Dec;26(12):2419-2443. doi: 10.1007/s10995-022-03556-6. Epub 2022 Oct 8.
A conflicting body of evidence suggests localized periodontal inflammation spreads systemically during pregnancy inducing adverse pregnancy outcomes. This systematic review and meta-analysis aim to specifically evaluate the relationship between periodontitis and preeclampsia.
Electronic searches were carried out in Medline, Pubmed, Embase, Lilacs, Cochrane Controlled Clinical Trial Register, CINAHL, ClinicalTrials.gov, and Google Scholar with no restrictions on the year of publication. We identified and selected observational case-control and cohort studies that analyzed the association between periodontal disease and preeclampsia. This meta-analysis was conducted following the PRISMA checklist and MOOSE checklist. Pooled odds ratios, mean difference, and 95% confidence intervals were calculated using the random effect model. Heterogeneity was tested with Cochran's Q statistic.
Thirty studies including six cohort- and twenty-four case-control studies were selected. Periodontitis was significantly associated with increased risk for preeclampsia (OR 3.18, 95% CI 2.26 - 4.48, p < 0.00001), especially in a subgroup analysis including cohort studies (OR 4.19, 95% CI 2.23 - 7.87, p < 0.00001). The association was even stronger in a subgroup analysis with lower-middle-income countries (OR 6.70, 95% CI 2.61 - 17.19, p < 0.0001).
Periodontitis appears as a significant risk factor for preeclampsia, which might be even more pronounced in lower-middle-income countries. Future studies to investigate if maternal amelioration of periodontitis prevents preeclampsia might be warranted.
有大量相互矛盾的证据表明，局部牙周炎炎症会在怀孕期间全身扩散，从而导致不良的妊娠结局。本系统评价和荟萃分析旨在专门评估牙周炎与子痫前期之间的关系。
在 Medline、Pubmed、Embase、Lilacs、Cochrane 对照临床试验注册、CINAHL、ClinicalTrials.gov 和 Google Scholar 中进行电子检索，对发表年份没有限制。我们确定并选择了分析牙周病与子痫前期之间关系的观察性病例对照和队列研究。本荟萃分析遵循 PRISMA 清单和 MOOSE 清单进行。使用随机效应模型计算汇总优势比、均数差和 95%置信区间。使用 Cochran's Q 统计量检验异质性。
共纳入 30 项研究，包括 6 项队列研究和 24 项病例对照研究。牙周炎与子痫前期风险增加显著相关（OR 3.18，95%CI 2.26 - 4.48，p < 0.00001），特别是在包括队列研究的亚组分析中（OR 4.19，95%CI 2.23 - 7.87，p < 0.00001）。在中低收入国家的亚组分析中，这种相关性甚至更强（OR 6.70，95%CI 2.61 - 17.19，p < 0.0001）。
牙周炎似乎是子痫前期的一个显著危险因素，在中低收入国家可能更为明显。未来的研究可能需要调查是否可以通过改善母亲的牙周炎来预防子痫前期。
