The association of periodontitis, maternal obesity with adverse pregnancy outcomes: a systematic review

Background Periodontitis and maternal obesity are prevalent inflammatory conditions that may independently and collectively influence adverse pregnancy outcomes. However, evidence examining their combined impact remains limited. Methods This systematic review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD42023443741). Electronic databases including PubMed, Scopus, Web of Science, and Cochrane Library were searched for studies published between 2013 and 2023. Observational studies assessing the association between periodontitis, maternal obesity, and adverse pregnancy outcomes were included. Due to heterogeneity in study designs, exposure definitions, and outcome measures, meta-analysis was not feasible, and a qualitative synthesis was performed. Results A total of 219 records were identified, of which 6 studies met the inclusion criteria. The majority of included studies demonstrated an association between periodontitis and adverse pregnancy outcomes, including preterm birth, low birth weight, and preeclampsia. Several studies also suggested a possible combined effect of maternal obesity and periodontitis, amplifying the risk of adverse outcomes. Risk of bias assessment showed that all included studies were of moderate methodological quality. However, inconsistencies were observed across studies, likely due to methodological differences and residual confounding. Conclusion This review suggests that periodontitis, particularly when combined with maternal obesity, may increase the risk of adverse pregnancy outcomes. The findings suggest that oral health assessment and weight management may be important considerations during prenatal care; however, further prospective studies are required before definitive clinical recommendations can be made. Trial registration Register Name: PROSPERO (International Prospective Register of Systematic Reviews). Registration Number: CRD42023443741.