| Abstract
| - The delivery of preterm babies (under 37 weeks f gestation) is a significant public health issue. This problem is associated with both high postnatal mortality rate and higher risk of morbidity due to sequelae. Despite clinical researches, in 40% of cases, aetiology of preterm birth remains unknown and the preterm birth rates have not only not declined but also have increased over the last two decades (7% in France, 13% in the United States). A potential link between odontology and preterm babies is studied for years. In 1996, some authors described periodontal disease as a risk factor of preterm birth. Since then, numerous studies were published to assert or deny this hypothesis. A classical meta-analysis of these works is quasi impossible due to huge methodological discrepancies between studies: definition and evaluation of periodontal disease are fluctuating, the criteria “low weight babies” is added to “preterm birth” by some authors, etc. Even if an increasing of preterm birth rate was statistically proved in women with periodontal disease, it will not inevitably signify that periodontal disease is a risk factor of preterm birth, the events could be concomitant without a cause to effect link. So, nowadays, decreeing recommendations of oral care to pregnant women in order to prevent preterm birth based on so different studies and conclusions seems to be not reasonable. However, biology seems to be a promising area of research which should clarify the link between periodontal disease and preterm birth in the next few years. The suggested mechanisms need to be proved based on studies of the concentrations and impact on pregnancy of some molecules produced due to periodontal disease.
- En raison du taux d’incidence élevé, de la gravité des complications, de la lourdeur de la prise en charge et des possibilités en terme de prévention, les nouveau-nés prématurés représentent un des domaines d’intérêt pour la recherche médicale. La médecine bucco-dentaire prend part à ces travaux de recherche depuis 1996 en essayant de déterminer l’existence d’un lien entre les maladies parodontales et la prématurité. Nous proposons ici une revue critique de la littérature internationale portant sur les travaux tendant à établir l’existence de ce lien, à la fois sur la forme (méthodologie) et sur le fond (conclusions). Toute tentative de méta-analyse et d’élaboration de recommandations achoppe sur le caractère individuel de chaque étude car les critères utilisés pour définir la maladie parodontale et la prématurité sont différents ce qui conduit inéluctablement à des conclusions divergentes. Cependant, en étudiant la bactériémie et l’inflammation spécifiques des maladies parodontales et leurs conséquences sur la grossesse, la biologie semble constituer un axe de recherche prometteur qui devrait permettre de préciser le lien entre maladie parodontale et prématurité.
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