Background: Association studies between maternal periodontitis and an elevated risk for preeclampsia have shown conflicting results. The aims of the present case-control study were: 1) to evaluate the association between maternal periodontitis and preeclampsia before and after matching, assessing confounding and interaction; and 2) to evaluate the influence of the extent and severity of periodontal parameters, bleeding on probing (BOP), probing depth (PD), and clinical attachment loss (CAL), in association with preeclampsia.
Methods: Initially, 1,206 Brazilian women were included and divided into a control group (1,042 non-preeclamptic women who gave birth to infants with adequate gestational age and birth weight) and a case group (164 preeclamptic women). Further, 125 preeclamptic women were matched according to age, chronic hypertension, and primiparity to 375 non-preeclamptic women randomly selected from the control group. Maternal periodontitis was defined as PD > or =4 mm and CAL > or =3 mm at the same site in at least four teeth. The effect of variables of interest and confounding were assessed by univariate and multivariate analysis.
Results: After controlling for confounders, maternal periodontitis was included in the multivariate final model (odds ratio [OR] = 1.94; 95% confidence interval [CI]: 1.37 to 2.77; P <0.001) and remained associated with preeclampsia after matching (OR = 1.52; 95% CI: 1.01 to 2.29; P = 0.045). The odds of preeclampsia were associated with an increase in the number of sites with BOP and PD and CAL > or =4 mm.
Conclusion: Maternal periodontitis is a risk factor associated with preeclampsia, emphasizing the importance of periodontal care in prenatal programs.