Use of nonalcohol antibacterial mouth rinse containing cetylpyridinium chloride (CPC) decreases the incidence of preterm births, according to a study presented today at the Society for Maternal-Fetal Medicine (SMFM) annual meeting in San Francisco.
"This research demonstrated that reducing the severity of periodontal disease has a direct correlation with preterm birth," said study author Marjorie Jeffcoat, DMD, a professor of periodontics at the University of Pennsylvania School of Dental Medicine. "Preterm birth is the major cause of perinatal mortality and morbidity worldwide and still difficult to predict and prevent. So when we found that something as simple as mouthwash could change the outcomes, we were very excited."
The study was funded by the Commonwealth of Pennsylvania and Procter & Gamble. It was a controlled blind clinical study of pregnant women at six to 20 weeks gestation with periodontal disease who refused dental care and did not have obstetric infections.
Treatment was assigned to blocks of four subjects based on four strata: prior preterm birth (yes or no) and smoking (yes or no). Each block assigned three controls and one rinse subject. Of the 204 subjects, 155 served as untreated controls (exposure group), and 49 (nonexposure group) received an antimicrobial CPC nonalcohol mouth rinse, Procter & Gamble's Crest Pro-Health.
The primary outcome was spontaneous preterm birth less than 35 weeks. Dental exams were performed at baseline and prior to delivery. Gestational age and birth weight was recorded by abstractors. Groups were compared using the analysis of variance statistical test. Dichotomous variables were compared using the chi-square test; logistic regression was used to calculate odds ratios.
The researchers found no significant difference at baseline in smoking, prior preterm birth, or alcohol consumption between the groups. Maternal age was higher in the rinse group than in the control group, and no adverse events were observed, they reported.
The incidence of preterm birth less than 35 weeks was significantly lower in the subjects using the rinse compared with the controls, according to the researchers, and gestational age and birth weight (adjusted for maternal age) were significantly higher in the rinse group.
