In the obstetrical search for greener pastures when common sense and good nutrition is not the basis of care, ORGYN.com (subscription free) this week shows us not one, but two, reports that show their current methods of treating preterm birth are out to lunch.

Progressive gum disease predicts very preterm birth
Source: Obstetrics & Gynecology 2006; 107: 29-36
Estimating whether maternal periodontal disease is predictive of preterm or very preterm birth.

Maternal gum disease in early pregnancy is an independent predictor of preterm delivery, researchers have found.

And progression of gum disease during pregnancy is associated with an increased risk of delivering very preterm, the study, by Steven Offenbacher (University of North Carolina at Chapel Hill, USA) and colleagues, also showed.

While an association between maternal oral infections and abnormal pregnancy outcomes has been previously reported, some studies have failed to confirm the link.

To investigate further, Offenbacher et al prospectively studied the obstetric outcomes of 1020 pregnant women, who underwent periodontal examinations antepartum—at less than 26 weeks’ gestation—and after delivery.

After adjusting for potential confounders, the researchers found that the relative risk of preterm birth was 60 percent higher for women with moderate-severe periodontal disease than for women with healthy gums, while that for spontaneous preterm birth was increased two fold. The unadjusted rate of very preterm delivery was significantly higher for women who experienced progression of periodontal disease during pregnancy than for women without disease progression.

Offenbacher and team say the findings “indicate that maternal periodontal disease progression during pregnancy may, in part, contribute to deliveries at less than 32 weeks of gestation.”

Posted: 17 January 2006

How interesting that Dr. Price, in his comprehensive research into nutrition and it’s affect on oral health shows conclusively that nutrition is the backbone to a cavity-free, healthy smile.

For example, when Price visited his first people, isolated Swiss mountain villagers, he noticed right away that the children’s teeth were covered with a thin film of green slime, yet they had no tooth decay.

Dr. Price also noticed that, in addition to their healthy teeth and gums, all the people he discovered were hardy and strong, despite the sometimes difficult living conditions they had to endure. Eskimo women, for example, gave birth to one healthy baby after another with little difficulty.

Next up, treatments used to prevent (prophilactic) preterm labour not only caused it, it caused severe preterm birth in pregnancies prior to 30 weeks gestation.

Preterm birth drug may increase early delivery risk
Source: An International Journal of Obstetrics and Gynaecology 2006; Not yet available online
Investigating whether metronidazole reduces preterm birth rates in high-risk women.

A drug often used for the prevention of preterm birth may actually increase the risk of early delivery, a UK study has found.

The effect was so strong that the randomized study was stopped early, and the researchers, led by Andrew Shennan from St. Thomas’ Hospital in London, concluded that they “do not recommend continued use of metronidazole in the clinical setting for the prevention of preterm delivery.”

For the study, 900 pregnant women were tested for vaginal fetal fibronectin (fFN), which is a known indicator for high-risk preterm delivery at 24 and 27 weeks’ gestation. Of the 116 (13%) women who tested positive for the marker, 99 were randomly assigned to receive a 1-week course of oral metronidazole or placebo.

Preterm delivery, before 37 weeks’ gestation, was 60 percent more common among the women given metronidazole than among those assigned to receive placebo. Moreover, there was an almost doubling in the risk of delivery before 30 weeks’ gestation with active treatment.

On the basis of their study and others, the researchers say “there is evidence to suggest that the commonly used antimicrobial agent metronidazole when used alone has no benefit in the prevention of preterm delivery in high-risk women.

“Indeed, this and other clinical trials suggest positive harm,” the team concludes.

Posted: 16 January 2006

When will physicians stop using mothers and babies as their guinea pigs and demand nutrition be taught in medical schools? Is that too much to ask?