Gaps in Knowledge About the Association Between Maternal Periodontitis and Adverse Obstetric Outcomes: An Umbrella Review

Scientific literature has established that the periodontal condition during pregnancy could be associated with obstetric/neonatal morbidity, and these effects have an important relationship with problems during childhood and cardiovascular disease in adulthood. This umbrella review aimed to summarize the results about the association between maternal periodontitis and obstetric complications (low birth weight, preterm delivery, and preeclampsia) and identify the gaps in the scientific literature. An umbrella review of systematic reviews with or without meta-analysis was performed. Quality evaluation and descriptive analysis of the characteristics of the included studies were conducted. Nineteen systematic reviews/meta-analyses were considered. In total, the systematic reviews included 99 observational studies. Most of the reviews established an association between maternal periodontitis and a higher risk of low birth weight, preterm delivery, and preeclampsia. The magnitude and statistical significance of this relationship are influenced by the context in which the studies have been conducted. Gaps were identified in the definition/evaluation of periodontal disease, criteria of gestational age for study purposes, and potential confounders, among others. Although scientific literature has established an association among the analyzed pathologies, conceptual and methodological gaps were identified, and they should be considered as integral components when this association is investigated.