Oral Infection Is Associated With Increased Rate of Preterm Birth

In humans preterm birth (Latin: partus praetemporaneus or partus praematurus) is the birth of a baby of less than 37 weeks gestational age. The cause of preterm birth is in many situations elusive and unknown; many factors appear to be associated with the development of preterm birth, making the reduction of preterm birth a challenging proposition.
 
Premature birth is defined either as the same as preterm birth, or the birth of a baby before the developing organs are mature enough to allow normal postnatal survival. Premature infants are at greater risk for short and long term complications, including disabilities and impediments in growth and mental development. Significant progress has been made in the care of premature infants, but not in reducing the prevalence of preterm birth. Preterm birth is among the top causes of death in infants worldwide.
 
In humans the usual definition of preterm birth is birth before a gestational age of 37 complete weeks, that is, a birth before the beginning of week number 38. In the normal human fetus, several organ systems mature between 34 and 37 weeks, and the fetus reaches adequate maturity by the end of this period. One of the main organs greatly affected by premature birth is the lungs. The lungs are one of the last organs to develop in the womb; because of this, premature babies typically spend the first days/weeks of their life on a ventilator. Therefore, a significant overlap exists between preterm birth and prematurity. Generally, preterm babies are premature and term babies are mature. Prematurity can be reduced to a small extent by using drugs to accelerate maturation of the fetus, and to a greater extent by preventing preterm birth.
 
US scientists have found a strong link between the success of gum disease treatment and the likelihood of giving birth prematurely, according to new research published in BJOG: An International Journal of Obstetrics and Gynaecology. 
 
There are a number of factors such as low body mass index, alcohol consumption and smoking which are associated with an increased rate of preterm birth. More recently researchers have reported that oral infection may also be associated with such an increase. 
 
This study looked at 322 pregnant women who all had gum disease. The group was split into two groups; one group received scaling and root planning - cleaning above and below the gum-line - and oral hygiene instruction while the other group only received oral hygiene instruction. 
 
The incidence of preterm birth was high in both the treatment group and the untreated group; 52.4% of the women in the untreated control group had a preterm baby compared with 45.6% in the treatment group. These differences were not statistically significant. 
 
However, the researchers then looked at whether the success of treatment was associated with the rate of preterm birth. The women were examined 20 weeks after the initial treatment and success was characterized by reduced inflammation and no increase in loosening of the teeth. 
 
Within the treatment group of 160 women, 49 women were classed as having successful gum treatment and only four had a preterm baby (8%). In comparison, 111 women had unsuccessful treatment and 69 of these (62%) had preterm babies. These differences are highly statistically significant. 
 
The results show that pregnant women who were resistant to scaling and root planning were significantly more likely to deliver preterm babies than those where it was successful. 
 
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