Use of antiseptic mouthrinse during pregnancy and pregnancy outcomes: a randomised controlled clinical trial in rural China.

OBJECTIVE: To determine whether an antimicrobial mouthrinse intervention reduces adverse pregnancy outcomes in a low-resource rural area. DESIGN: Randomised controlled trial. SETTING: A county-level maternal health care hospital in China. SAMPLE: Pregnant women of less than 20 weeks of gestation having periodontal disease. METHODS: Women with periodontal disease were randomised into the intervention (n = 232) and control group (n = 234). Participants in the intervention group were provided with free mouthrinse (alcohol-free mouthrinse containing 0.7% cetylpyridinium chloride) throughout the pregnancy and given education on oral health. Women in the control group only received oral hygiene education. All participants had a periodontal re-examination at the third trimester and were followed-up to childbirth. MAIN OUTCOME MEASURES: The primary outcome was gestational age. Secondary outcomes included birthweight, periodontal disease score, pregnancy complications (small-for-gestational-age, gestational hypertension, gestational diabetic mellitus, severe anaemia, premature rupture of membrane). RESULTS: The general periodontal status of the intervention group at the third trimester was significantly better than that of the control group (measured by periodontal disease score: 11.26 +/- 3.60 versus 11.92 +/- 3.01; P = 0.04). There was no difference in pregnancy outcome between the two groups except for premature rupture of the membranes. The women in the intervention group had a significantly reduced risk of premature rupture of the membranes compared with the control group (1.4 versus 5.7%, OR = 0.23, 95% CI 0.07-0.84; P = 0.03). CONCLUSIONS: The mouthrinse intervention during pregnancy improved periodontal health. The intervention did not lead to a change in gestational age but it reduced the rate of premature membrane rupture. Further studies are needed to explore the biological mechanism of this association. TWEETABLE ABSTRACT: Use of antiseptic mouthrinse during pregnancy may improve maternal oral health and pregnancy outcomes.