Browsing by Author "Tiago, Madalena Ferreira"
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- Periodontal disease and adverse pregnancy outcomes : an umbrella reviewPublication . Tiago, Madalena Ferreira; Machado, Vanessa; Botelho, JoãoObjective: To appraise the methodological quality and the strength of evidence on the association between maternal periodontitis and adverse pregnancy outcomes (APOs). Materials & Methods: PubMed, Cochrane Database of Systematic Reviews, Web of Science, and LILACS were searched from inception to July 2022, without date or language restrictions. All systematic reviews reporting periodontal disease and APOs were included. The risk of bias was assessed through A MeaSurement Tool to Assess Systematic Reviews, and we estimated the meta-analytical strengths and validity of the evidence. The fail-safe number (FSN) was calculated for statistically significant meta-analyses. Results: The association of periodontal disease with APOs was explored on 26 systematic reviews, of which 14 conducted meta-analytical analysis. From the 28 estimates, periodontal disease had strong association with 3 APOs: preterm birth (PTB), low birth weight (LBW) and gestational diabetes mellitus (GDM). PTB and LBW revealed all the remaining strength levels, yet preeclampsia only showed suggestive and weak evidence. When analyzing the consistency of the significant estimates (weak to strong), only 8.7% estimates showed to be likely to change in the future, according to FSN statistics. None of the strong meta-analytical estimates had the possibility to change in the future, showing consistency. The impact of periodontal treatment effect on APOs were explored on 19 systematic reviews, of which 11 conducted meta-analysis. Overall, 42 meta-analyses were included and showed that periodontal treatment had no strong association with APOs. PTB revealed all the remaining strength levels, yet LBW only showed suggestive and weak evidence. Conclusion: Strong and highly suggestive evidence from observational studies support an association between maternal periodontitis and a higher risk of PTB, LBW, GDM and preeclampsia. The level of evidence on the effect of periodontal treatment to prevent APOs is still uncertain and requires future trials to draw definite and robust conclusions.