91av

WOMEN with severe gum disease are up to seven times more likely to have
premature babies. This means that poor oral health could pose as big a risk to a
pregnant woman as smoking or drinking, suggests a new study from Alabama.

Smaller studies have previously hinted at a correlation between bad gums and
premature birth. But Marjorie Jeffcoat and her team at the Alabama University
School of Dentistry in Birmingham is looking at a much larger set of pregnant
women, 1313 so far. Their study shows that those with poor oral health are
significantly more likely to give birth early.

“This is the newest risk factor to emerge,” says Robert Pick, a professor of
periodontics at Northwestern University in Chicago. “There’s a definite
correlation here.”

The Alabama team examined women’s mouths when they were between 21 and 24
weeks pregnant. Then they noted the timing of the women’s deliveries. Jeffcoat’s
results, published this month, show that 13.6 per cent of women gave birth
before 37 weeks, and a significant proportion of those had poor oral health
before they had their baby. Women with gum disease were between 4 and 7 times
more likely to deliver their babies early.

The worse the gum disease, the higher the chance that the baby would be born
very early. Out of the 34 women who had their babies before 32 weeks of
pregnancy, all but four had severe gum disease, Jeffcoat says. While startling,
these results “should not make women feel guilty” if their babies are born
early, she says. Instead, they should realise how important it is to prevent gum
disease from developing.

A pregnant woman should be especially careful about taking care of her teeth,
because hormonal changes during pregnancy make gums more vulnerable to disease,
says Pick. There’s an old saying that “you lose a tooth per pregnancy”, he says,
and it continues to ring true as doctors uncover the link between poor oral
health and early births.

Jeffcoat’s study does not prove that gum disease is directly responsible for
premature births. However, her results tie in with previous studies that suggest
that bacteria in the gums might be partly to blame
(91av, 6 February 1999, p 22).

But it may be that having gum disease is simply associated with some other
factor that triggers early delivery, says Jeffcoat. If this is true, treating
gum disease might not prevent premature births. To test this theory, Jeffcoat
and her team are treating 400 pregnant women with gum disease to see if this
will indeed cut the number of premature births.