{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:01:59Z","timestamp":1792152119470,"version":"4.4.0"},"reference-count":68,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T00:00:00Z","timestamp":1684800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Funda\u00e7\u00e3o para Ci\u00eancia e Tecnologia","award":["2022.02119.PTDC"],"award-info":[{"award-number":["2022.02119.PTDC"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This umbrella review aims to appraise the methodological quality and strength of evidence on the association between maternal periodontitis and adverse pregnancy outcomes (APOs). PubMed, CENTRAL, Web-of-Science, LILACS, and Clinical Trials were searched until February 2023, without date or language restrictions. Two authors independently screened studies, extracted data, performed the risk-of-bias analysis, and estimated the meta-analytic strengths and validity and the fail-safe number (FSN). A total of 43 SRs were identified, of which 34 conducted meta-analyses. Of the 28 APOs, periodontitis had a strong association with preterm birth (PTB), low birth weight (LBW), and gestational diabetes mellitus (GDM), PTB and LBW showed all levels of strength, and pre-eclampsia showed only suggestive and weak strength. Regarding the consistency of the significant estimates, only 8.7% were likely to change in the future. The impact of periodontal treatment on APOs was examined in 15 SRs, 11 of which conducted meta-analyses. Forty-one meta-analyses were included and showed that periodontal treatment did not have a strong association with APOs, although PTB revealed all levels of strength and LBW showed only suggestive and weak evidence. Strong and highly suggestive evidence from observational studies supports an association of periodontitis with a higher risk of PTB, LBW, GDM, and pre-eclampsia. The effect of periodontal treatment on the prevention of APOs is still uncertain and requires future studies to draw definitive and robust conclusions.<\/jats:p>","DOI":"10.3390\/jcm12113635","type":"journal-article","created":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T01:29:26Z","timestamp":1684891766000},"page":"3635","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Adverse Pregnancy Outcomes and Maternal Periodontal Disease: An Overview on Meta-Analytic and Methodological Quality"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2503-260X","authenticated-orcid":false,"given":"Vanessa","family":"Machado","sequence":"first","affiliation":[{"name":"Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Caparica, Portugal"},{"name":"Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madalena","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Caparica, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu\u00edsa","family":"Lopes","sequence":"additional","affiliation":[{"name":"Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Caparica, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0167-4077","authenticated-orcid":false,"given":"Jos\u00e9 Jo\u00e3o","family":"Mendes","sequence":"additional","affiliation":[{"name":"Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Caparica, Portugal"},{"name":"Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o","family":"Botelho","sequence":"additional","affiliation":[{"name":"Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Caparica, Portugal"},{"name":"Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1111\/prd.12371","article-title":"Polymicrobial Communities in Periodontal Disease: Their Quasi-Organismal Nature and Dialogue with the Host","volume":"86","author":"Hajishengallis","year":"2021","journal-title":"Periodontology 2000"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1038\/s41577-020-00488-6","article-title":"Local and Systemic Mechanisms Linking Periodontal Disease and Inflammatory Comorbidities","volume":"21","author":"Hajishengallis","year":"2021","journal-title":"Nat. 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