Periodontal Disease Activity Measured by the Benzoyl-DL-Arginine- Naphthylamide Test Is Associated With Preterm Births

Background: Infection is a risk factor for preterm birth. This study was conducted in the field and addressed the link be-tween periodontal pathogens measured with the benzoyl-DL-arginine-naphthylamide (BANA) test and preterm birth. Methods: This prospective study was performed in Chan-ghua, Taiwan. Periodontal examinations included the plaque index, papillary bleeding scores, and measurement of the BANA enzyme in plaque samples at the second and third tri-mesters. Independent variables included maternal demo-graphic characteristics, previous pregnancy histories, risk factors, plaque and gingivitis scores, and current pregnancy outcomes. Results: There were 19 (7%) preterm deliveries among the 268 subjects. A history of a previous preterm birth and low birth weight, frequency of prenatal visits, preterm uterine con-tractions, antepartum hemorrhages, placenta previae, and preterm premature rupture of membranes were significantly related to preterm birth (P = 0.035, 0.027, <0.001, 0.025, 0.006, 0.014, and <0.001, respectively). Maternal weight gain was higher with a normal term delivery (P = 0.003). Mul-tivariable logistic regression analyses showed that the number of BANA-infected sites in the third trimester (odds ratio [OR]: 5.89; 95 % confidence interval [CI]: 1.5 to 31.6), maternal weight gain (OR: 0.78; 95 % CI: 0.65 to 0.91), antepartum hemorrhages (OR: 10.0; 95 % CI: 2.2 to 46.9), and preterm premature rupture of membranes (OR: 12.6; 95 % CI: 3.97 to 42.71) had significant influences on preterm-birth outcomes. Conclusions: BANA-positive plaque in the third trimester was associated with preterm births after controlling for other risk factors. The BANA test can be used to screen pregnant women at chairside and/or bedside to apply suitable interven-tion tactics. J Periodontol 2010;81:982-991