Association between periodontitis, prematurity, low birth weight, and CRP levels – A case–control study

Background

To analyze the role of periodontal infections in pre-term low birth weight deliveries and to prevent prematurity.

Aim

To evaluate the association between maternal periodontal disease and adverse pregnancy outcome and to assess the CRP levels as the possible mediator.

Methods

A retrospective case–control study conducted during a one year period from amongst the post-natal women who delivered an infant before 37 weeks gestation (Study group) and after 37 weeks gestation (Control group) selected on a 1:1 ratio. All the study participants underwent an intra-oral examination by a qualified periodontologist within 72 h postpartum to measure probing depth and CAL. Also, 5 ml of blood was drawn for estimation of C-reactive protein (CRP) levels in both groups.

Results

Analysis of maternal periodontal disease in both groups showed a significantly greater number of mothers with generalized chronic periodontitis in the case group than in the control group and that the adjusted Odds Ratio for the association between periodontitis and preterm labor was 4.78. Also, the gestational age at delivery was found to be inversely proportional to the degree of periodontitis as those mothers with severe periodontitis delivered the most preterm infants with GA of 30.5 weeks. It was also seen that the mean birth weight also decreased with increasing severity of periodontitis with a mean birth weight of 1.2 kg in severe periodontitis patients. The CRP levels were higher in the cases than in the controls and were found to increase with increasing severity of periodontitis.

Conclusion

The study concludes that there is a significant association between periodontitis and preterm labor and a significant correlation between increased CRP levels, increasing severity of periodontitis and prematurity. As periodontitis is a treatable disease, prematurity can be prevented with early diagnosis.