Background: It has been suggested that periodontitis is associated with systemic alterations such as adverse pregnancy outcomes. However, some conflicting results have been reported. This case‐control study was conducted to determine the association between maternal periodontitis and preterm birth (PTB), low birth weight (LBW), and intrauterine growth restriction (IUGR).Methods: A total of 1,305 Brazilian women from multiethnic groups were enrolled and divided into four groups: control group (1,042 women who gave birth to infants with adequate gestational age and birth weight); PTB group (238 women, gestational age <37 complete weeks); LBW group (235 women, birth weight <2,500 g); and IUGR group (77 women who gave birth to infants with fetal growth retardation). Periodontitis was defined as the presence of at least four teeth with one or more sites with probing depth ≥4 mm and clinical attachment loss ≥3 mm. The effects of variables of interest, confounders, and interaction were tested through univariate and multivariate logistic regression tests.Results: After adjusting for variables of interest, maternal periodontitis was retained in the final model for PTB (odds ratio [OR] = 1.77; 95% confidence interval [CI]: 1.12 to 2.59), LBW (OR = 1.67; 95% CI: 1.11 to 2.51), and IUGR (OR = 2.06; 95% CI: 1.07 to 4.19). When the interaction between periodontitis and previous PTB was tested, an OR of 5.94 (P <0.001), 9.12 (P <0.001), and 18.90 (P <0.001) was observed for PTB, LBW, and IUGR, respectively.Conclusions: Maternal periodontitis is associated with an increased risk for PTB, LBW, and IUGR. Results emphasize the importance of periodontal care in prenatal health programs.

Background: Association studies between maternal periodontitis and an elevated risk for preeclampsia have shown conflicting results. The aims of the present case‐control study were: 1) to evaluate the association between maternal periodontitis and preeclampsia before and after matching, assessing confounding and interaction; and 2) to evaluate the influence of the extent and severity of periodontal parameters, bleeding on probing (BOP), probing depth (PD), and clinical attachment loss (CAL), in association with preeclampsia.Methods: Initially, 1,206 Brazilian women were included and divided into a control group (1,042 non‐preeclamptic women who gave birth to infants with adequate gestational age and birth weight) and a case group (164 preeclamptic women). Further, 125 preeclamptic women were matched according to age, chronic hypertension, and primiparity to 375 non‐preeclamptic women randomly selected from the control group. Maternal periodontitis was defined as PD ≥4 mm and CAL ≥3 mm at the same site in at least four teeth. The effect of variables of interest and confounding were assessed by univariate and multivariate analysis.Results: After controlling for confounders, maternal periodontitis was included in the multivariate final model (odds ratio [OR] = 1.94; 95% confidence interval [CI]: 1.37 to 2.77; P <0.001) and remained associated with preeclampsia after matching (OR = 1.52; 95% CI: 1.01 to 2.29; P = 0.045). The odds of preeclampsia were associated with an increase in the number of sites with BOP and PD and CAL ≥4 mm.Conclusion: Maternal periodontitis is a risk factor associated with preeclampsia, emphasizing the importance of periodontal care in prenatal programs.

Performance, rumen development, and metabolism of male Holstein calves (n=54) were evaluated according to 1 of 3 liquid feeding strategies: 4 L of milk replacer (MR)/d until 60 d old (4 L-60 d), 6L of MR/d until 29 d old and 4 L/d from 30 to 60 d (6L-29 d/4 L-60 d), or 6L of MR/day until 60 d old (60 d-6L). Water and starter were provided ad libitum. Intakes of MR and starter were monitored daily and body weight (BW) weekly. Blood samples for glucose and insulin concentrations and ruminal content samples for volatile fatty acids and ruminal ammonia concentrations were collected at 15, 30, 45, 60, 75, and 90 d of age. Six calves on each treatment were euthanized at 30, 60, and 90 d of age. Empty weights of forestomach and abomasum, papillae length, and mitotic index were measured. Average MR intake/d (expressed as a percent of BW) was greater for calves receiving 6L/d than for those receiving 4 L/d until 30 d of age. Calves on the 6 L-29 d/4 L-60 d had the smallest MR intake from 30 to 60 d old, followed by the 4 L-60 d and 6L-60 d treatments. Starter intake (kg of dry matter/day) did not differ between groups. It increased from 0.065 kg/d in the first month to 0.386 kg/d in the second month, and to 2.065 kg/d after weaning. Weight gain was greater for calves fed more MR in the first month, but no difference was observed during the second month. After weaning, 6L-60 d calves had greater rate of weight gain than others and were heavier at 30, 60, and 90 d of age. Weight of empty forestomachs, ruminal pH, and ammoniac nitrogen concentration were not different among groups. Propionate concentration was lower for 6 L-60 d calves, but acetate and butyrate concentrations were not influenced by MR feeding strategy. Calves fed more MR until d 30 had greater ruminal epithelium mitotic index. The different MR feeding strategies did not influence papillae length or ruminal epithelium thickness. Lesions such as ruminal parakeratosis or hyperkeratosis were not observed. The MR feeding strategy did not affect glucose concentration, but insulin was higher in 6L-60 d calves than in the other groups. Glucose concentration increased with age, whereas insulin decreased until 45 d old, and then started to increase until 90 d. In conclusion, MR feeding strategy did not influence ruminal development. Feeding calves 6 L of MR/d over 60 d resulted in greater rate of weight gain without negative effects on starter intake or forestomach development. The weight advantage that 6L-60 d calves obtained preweaning was maintained until 90 d of age.