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Maternal Periodontal Disease Is Associated With an Increased Risk for Preeclampsia

Boggess, Kim A. MD; Lieff, Susi PhD; Murtha, Amy P. MD; Moss, Kevin; Beck, James PhD; Offenbacher, Steven DDS, PhD

Original Research

OBJECTIVE To determine if maternal periodontal disease is associated with the development of preeclampsia.

METHODS A cohort of 1115 healthy pregnant women were enrolled at less than 26 weeks' gestation and followed until delivery. Maternal demographic and medical data were collected. Periodontal examinations were performed at enrollment and within 48 hours of delivery to determine the presence of severe periodontal disease or periodontal disease progression. Preeclampsia was defined as blood pressure greater than 140/90 on two separate occasions, and at least 1+ proteinuria on catheterized urine specimen. The potential effects of maternal age, race, smoking, gestational age at delivery, and insurance status were analyzed, and adjusted odds ratios for preeclampsia were calculated using multivariable logistic regression.

RESULTS During the study period, 763 women delivered live infants and had data available for analysis. Thirty-nine women had preeclampsia. Women were at higher risk for preeclampsia if they had severe periodontal disease at delivery (adjusted odds ratio 2.4, 95% confidence interval 1.1, 5.3), or if they had periodontal disease progression during pregnancy (adjusted odds ratio 2.1, 95% confidence interval 1.0, 4.4).

CONCLUSION After adjusting for other risk factors, active maternal periodontal disease during pregnancy is associated with an increased risk for the development of preeclampsia.

Maternal periodontal disease is associated with an increased risk for the development of preeclampsia.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, and Center for Oral and Systemic Diseases, University of North Carolina, Chapel Hill, North Carolina; and Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.

Address reprint requests to: Kim A. Boggess, MD, University of North Carolina School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, CB #7516, Chapel Hill, NC 27599; E-mail:

This study was supported by National Institute of Dental and Craniofacial Research grant no. DE-012453.

Received May 13, 2002. Received in revised form July 2, 2002. Accepted August 1, 2002.

© 2003 The American College of Obstetricians and Gynecologists