{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T11:56:27Z","timestamp":1793534187329,"version":"4.5.0"},"reference-count":103,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Maternal periodontitis has been consistently linked to adverse birth outcomes (ABOs). However, a causal relationship is not established due to potential unmeasured confounding factors in observational studies and inconclusive results from randomized controlled trials. This study aimed to assess the impact of unmeasured confounding factors in meta-analyses examining associations between maternal periodontitis and preterm birth (PTB) or low birth weight (LBW).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>PubMed and MEDLINE, Cochrane, Embase, and Google Scholar were searched for systematic reviews with meta-analyses of observational studies between 2002 and 2023. Systematic reviews with meta-analyses of observational studies were included if either PTB or LBW were the outcome and were published in English. The E-value analogue method was used to evaluate possible unmeasured confounding effects in random effects meta-analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>62 original studies from nine meta-analyses met the inclusion criteria. In relation to the exposure and outcome, the random-effects meta-analysis showed that even with an unmeasured confounder having a relative risk (RR) of 3.00, 80% of cohort studies evaluating PTB and 90% evaluating LBW would have an RR\u00a0&amp;gt;\u00a02.00.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Associations between maternal periodontitis and ABOs in observational studies appear robust to unmeasured confounding factors, supporting the hypothesis that maternal periodontitis is causally related to ABOs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pubmed\/fdaf056","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T08:28:08Z","timestamp":1747384088000},"page":"e408-e418","source":"Crossref","is-referenced-by-count":3,"title":["Unmeasured confounding in meta-analyses of observational studies evaluating maternal periodontitis and adverse birth outcomes"],"prefix":"10.1093","volume":"47","author":[{"given":"May","family":"Salama","sequence":"first","affiliation":[{"name":"Joint School of Public Health, Macon & Joan Brock Virginia Health Sciences at Old Dominion University , Norfolk, VA 23529,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Al-Taiar","sequence":"additional","affiliation":[{"name":"Joint School of Public Health, Macon & Joan Brock Virginia Health Sciences at Old Dominion University , Norfolk, VA 23529,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"McKinney","sequence":"additional","affiliation":[{"name":"College of Applied Medical Sciences , Qassim University, Al Mulaida District, Buraydah, Al-Qassim Province 51431,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad","family":"Al Otaibi","sequence":"additional","affiliation":[{"name":"College of Applied Medical Sciences , Qassim University, Al Mulaida District, Buraydah, Al-Qassim Province 51431,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sultan","family":"Al-Sallum","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina , 915 Greene Street Columbia, SC 29208,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric Mishio","family":"Bawa","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina , 915 Greene Street Columbia, SC 29208,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anwar T","family":"Merchant","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina , 915 Greene 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