학술논문

Preconception Periodontitis and Risk of Spontaneous Abortion in a Prospective Cohort Study.
Document Type
Article
Source
American Journal of Epidemiology. Sep2023, Vol. 192 Issue 9, p1509-1521. 13p.
Subject
*FAMILY planning
*CONFIDENCE intervals
*PERIODONTITIS
*MISCARRIAGE
*RISK assessment
*DESCRIPTIVE statistics
*DATA analysis software
*ODDS ratio
*LOGISTIC regression analysis
*LONGITUDINAL method
*DISEASE risk factors
*DISEASE complications
Language
ISSN
0002-9262
Abstract
Few studies have evaluated the association between periodontitis and spontaneous abortion (SAB), and all had limitations. We used data from the Pregnancy Study Online (PRESTO), a prospective preconception cohort study of 3,444 pregnancy planners in the United States and Canada (2019–2022), to address this question. Participants provided self-reported data on periodontitis diagnosis, treatment, and symptoms of severity (i.e. loose teeth) via the enrollment questionnaire. SAB (pregnancy loss at <20 weeks' gestation) was assessed via bimonthly follow-up questionnaires. Participants contributed person-time from the date of a positive pregnancy test to the gestational week of SAB, loss to follow-up, or 20 weeks' gestation, whichever came first. We fitted Cox regression models with weeks of gestation as the time scale to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs), and we used inverse probability of treatment weighting to account for differential loss to follow-up. We used probabilistic quantitative bias analysis to estimate the magnitude and direction of the effect of exposure misclassification bias on results. In weighted multivariable models, we saw no appreciable association between preconception periodontitis diagnosis (HR = 0.97, 95% CI: 0.76, 1.23) or treatment (HR = 1.01, 95% CI: 0.79, 1.27) and SAB. A history of loose teeth was positively associated with SAB (HR = 1.38, 95% CI: 0.88, 2.14). Quantitative bias analysis indicated that our findings were biased towards the null but with considerable uncertainty in the bias-adjusted results. [ABSTRACT FROM AUTHOR]