DIFFERENTIAL IMPACT OF PERIODONTAL TREATMENT STRATEGIES DURING PREGNANCY ON PERINATAL OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS

OBJECTIVES: This study aimed to evaluate the impact of different periodontal treatment strategies during pregnancy on perinatal outcomes. STUDY SELECTION: This systematic review and meta-analysis of clinical trials was conducted according to PRISMA guidelines to assess the effect of mouthwash in addition to scaling and root planning (SRPM) on pregnancy outcomes, including preterm birth, low birth weight, gestational age, and birth weight. Pooled risk ratios (RR), mean differences (MD), and 95% confidence intervals (CI) were calculated using the random effect model. RESULTS: Twenty trials involving 5938 participants, including thirteen trials comparing scaling and root planning (SRP) and seven trials comparing SRPM with control groups. SRPM was associated with reduced risk of preterm birth (RR = 0.37; 95%CI = 0.16-0.84; P = .017; I²=93.26%; P < .001; number needed to treat (NNT): 3), low birth weight (RR = 0.54; 95%CI = 0.40-0.74; P < .0001; I² = 0%; P = .46; NNT: 13), increased gestational age (MD = 0.78; 95%CI: 0.19-1.37; P = .009; I² = 87.15%; P < .001), and birth weight (MD = 121.77; 95%CI = 3.19-240.34; P = .044; I² = 80.68%; P < .001). There were no statistically significant differences in the analysis of SRP group, except for the increased birth weight (MD = 93.85; 95% CI = 3.27-184.42; P = .042; I² = 84.11%; P < .001). CONCLUSION: Using mouthwash in addition to scaling and root planning (SRPM) for the treatment of periodontal disease during pregnancy significantly improves perinatal outcomes.