Maternal Periodontitis Treatment and Child Neurodevelopment at 24 to 28 Months of Age

PEDIATRICS Vol. 127 No. 5 May 2011, pp. e1212-e1220

Bryan S. Michalowicz, DDS, MS^a, James S. Hodges, PhD^b, Richard C. Lussky, MD^c, Henrietta Bada, MD^d, Twila Rawson, PhD^e, L. Susan Buttross, MD^e, Claudia Chiriboga, MD, MPH^f, Anthony J. DiAngelis, DMD, MPH^g, M. John Novak, BDS, LDS, PhD^h, William Buchanan, DDS, MMdScⁱ, Dennis A. Mitchell, DMD^j, Panos N. Papapanou, DDS, PhD^j

BACKGROUND Some maternal infections are associated with impaired infant cognitive and motor performance. Periodontitis results in frequent bacteremia and elevated serum inflammatory mediators.

OBJECTIVE The purpose of this study was to determine if periodontitis treatment in pregnant women affects infant cognitive, motor, or language development.

METHODS Children born to women who had participated in a previous trial were assessed between 24 and 28 months of age by using the Bayley Scales of Infant and Toddler Development (Third Edition) and the Preschool Language Scale (Fourth Edition). Information about the pregnancy, neonatal period, and home environment was obtained through chart abstractions, laboratory test results, and questionnaires. We compared infants born to women treated for periodontitis before 21 weeks' gestation (treatment group) or after delivery (controls). In unadjusted and adjusted analyses, associations between change in maternal periodontal condition during pregnancy and neurodevelopment scores were tested by using Student's t tests and linear regression.

RESULTS A total of 411 of 791 eligible mother/caregiver-child pairs participated. Thirty-seven participating children (9.0%) were born at <37 weeks' gestation. Infants in the treatment and control groups did not differ significantly for adjusted mean cognitive (90.7 vs 91.4), motor (96.8 vs 97.2), or language (92.2 vs 92.1) scores (all P > .5). Results were similar in adjusted analyses. Children of women who experienced greater improvements in periodontal health had significantly higher motor and cognitive scores (P = .01 and .02, respectively), although the effect was small (1-point increase for each SD increase in the periodontal measure).

CONCLUSION Nonsurgical periodontitis treatment in pregnant women was not associated with cognitive, motor, or language development in these study children.