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Periodontal treatment among mothers with mild to moderate periodontal disease and preterm birth: reanalysis of OPT trial data accounting for selective survival.

Abstract：

Background:The Obstetrics and Periodontal Therapy (OPT) study, a randomized controlled trial, reported no effect of periodontal treatment on preterm birth. Even though there were more spontaneous abortions or stillbirths in the control group, sensitivity analyses using conventional approaches did not change the results. The development of newer epidemiological methods to assess bias caused by the truncated outcome, and the availability of OPT study data in the public domain, allowed us to reanalyse these data. Methods:We used the survivor average causal effect (SACE), also known as the principal strata effect, to correct potential bias resulting from unequal survival of fetuses in the treatment and control arms of the OPT study. Results:The risks of preterm and spontaneous abortions or stillbirths were respectively 49/413 (11.86%) and 5/413 (1.21%) in the periodontal treatment group, and 52/410 (12.68%) and 14/410 (3.33%) respectively in the control group. The risk differences (%) comparing periodontal treatment and control groups were -0.82%: 95% confidence interval (CI) -5.30% to 3.67% for preterm birth, and -2.12%: 95% CI -4.14% to -0.11% for spontaneous abortions or stillbirths before correction. Risk differences for preterm birth comparing periodontal treatment and control groups increased in magnitude, reached statistical significance and showed a beneficial effect of periodontal treatment after correction for bias using SACE. Conclusions:Periodontal treatment provided to mothers with mild to moderate periodontal disease before 21 weeks of gestation may prevent preterm births.

journal_name

Int J Epidemiol

journal_title

International journal of epidemiology

authors

Merchant AT,Sutherland MW,Liu J,Pitiphat W,Dasanayake A

doi

10.1093/ije/dyy089

subject

Has Abstract

pub_date

2018-10-01 00:00:00

pages

1670-1678

issue

5

eissn

0300-5771

issn

1464-3685

pii

5032469

journal_volume

47

pub_type

杂志文章,随机对照试验

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