Resumo Evidências recentes apontam para a influência de processos inflamatórios periodontais na ocorrência de baixo peso ao nascer. Embora muitos estudos empregaram métodos robustos de investigação, ainda não existe consenso sobre o tópico. Analisar sistematicamente a relação entre a periodontite materna e o baixo peso ao nascer. A busca por estudos foi realizada até abril de 2019. Os delineamentos de estudos incluídos foram coorte e caso-controle que estimaram a associação entre a periodontite e o baixo peso ao nascer, sem limite quanto ao idioma ou data da publicação. Análise de heterogeneidade dos estudos, análises de subgrupo e metanálises com modelo de efeitos randômicos foram realizadas. Foram estimadas as medidas de associação sumária por meio da Odds Ratio bruta e ajustada, com respectivos intervalos de confiança a 95%. A inspeção visual de gráficos foi empregada para avaliar viés de publicação. Um total de 21 artigos foram identificados e todos foram selecionados para a metanálise. O modelo final aponta que a periodontite em gestantes se associou ao baixo peso ao nascer (ORbruta=2,13; IC95%=1,60-2,83; I2=80,0% e ORajustada=2,64; IC95%=2,04-3,42; I2=17,4%). Gestantes com periodontite podem ter mais que o dobro de probabilidade de terem filhos com baixo peso ao nascer.

Abstract Recent evidence points to the influence of periodontal inflammatory processes on the occurrence of low birth weight. Although many studies employed robust investigation methods, there is still no general agreement on the relationship between maternal periodontitis and low birth weight. The search for studies was conducted until April 2019. The studies included cohort and case-control studies that estimated the association between periodontitis and low birth weight, with no restriction on language or date of publication. Analysis of the heterogeneity of studies, subgroup analyses and meta-analyses with a random effects model were performed. Summary association measurements were estimated using the crude and adjusted Odds Ratio, with respective 95% confidence intervals. Visual inspection of graphs was used to assess publication bias. A total of 21 articles were identified, all of which were selected for the meta-analysis. The final model indicates that periodontitis in pregnant women was associated with low birth weight (ORgross=2.13; CI95%=1.60-2.83; I2=80.0% and ORadjusted=2.64; CI95%=2.04-3.42; I2=17.4%). Pregnant women with periodontitis may be more than twice as likely to have low birth weight babies.

Resumo Evidências recentes apontam para a influência de processos inflamatórios periodontais na ocorrência de baixo peso ao nascer. Embora muitos estudos empregaram métodos robustos de investigação, ainda não existe consenso sobre o tópico. Analisar sistematicamente a relação entre a periodontite materna e o baixo peso ao nascer. A busca por estudos foi realizada até abril de 2019. Os delineamentos de estudos incluídos foram coorte e caso-controle que estimaram a associação entre a periodontite e o baixo peso ao nascer, sem limite quanto ao idioma ou data da publicação. Análise de heterogeneidade dos estudos, análises de subgrupo e metanálises com modelo de efeitos randômicos foram realizadas. Foram estimadas as medidas de associação sumária por meio da Odds Ratio bruta e ajustada, com respectivos intervalos de confiança a 95%. A inspeção visual de gráficos foi empregada para avaliar viés de publicação. Um total de 21 artigos foram identificados e todos foram selecionados para a metanálise. O modelo final aponta que a periodontite em gestantes se associou ao baixo peso ao nascer (ORbruta=2,13; IC95%=1,60-2,83; I2=80,0% e ORajustada=2,64; IC95%=2,04-3,42; I2=17,4%). Gestantes com periodontite podem ter mais que o dobro de probabilidade de terem filhos com baixo peso ao nascer.

Abstract Recent evidence points to the influence of periodontal inflammatory processes on the occurrence of low birth weight. Although many studies employed robust investigation methods, there is still no general agreement on the relationship between maternal periodontitis and low birth weight. The search for studies was conducted until April 2019. The studies included cohort and case-control studies that estimated the association between periodontitis and low birth weight, with no restriction on language or date of publication. Analysis of the heterogeneity of studies, subgroup analyses and meta-analyses with a random effects model were performed. Summary association measurements were estimated using the crude and adjusted Odds Ratio, with respective 95% confidence intervals. Visual inspection of graphs was used to assess publication bias. A total of 21 articles were identified, all of which were selected for the meta-analysis. The final model indicates that periodontitis in pregnant women was associated with low birth weight (ORgross=2.13; CI95%=1.60-2.83; I2=80.0% and ORadjusted=2.64; CI95%=2.04-3.42; I2=17.4%). Pregnant women with periodontitis may be more than twice as likely to have low birth weight babies.

ABSTRACT OBJECTIVE To investigated the effect of oropharyngeal colostrum immunotherapy in reducing the time required for very low birth weight preterm newborns (VLBW-PTNB: < 1,500g and < 37 weeks) to achieve full enteral nutrition. METHODS Literature search was conducted using four databases, including gray literature, with additional manual search of the references of selected articles. Eligibility criteria consisted of randomized clinical trials, without restriction regarding the date or language of the publication. Two independent reviewers performed the article selection and data extraction. The random-effects meta-analysis used a non-standard technique to assess the mean difference in days to achieve full enteral nutrition, carried out by the Stata 15 statistic program. RESULTS The systematic review comprised 10 studies, and five were selected for meta-analysis, with a population of 764 VLBW-PTNB and gestational age of birth between 25 and 32 weeks. The studies were conducted between 2011 and 2018 in North America, Asia and Africa, with only one conducted in South America. Altogether, they reported the number of days it took 708 VLBW-PTNB to achieve full enteral nutrition, with newborns treated with immunotherapy showing a shorter time in only three studies. Meta-analysis showed a mean difference of -4.26 days, (95% CI -7.44; -1.08d), with high heterogeneity (I2 = 83.1%). CONCLUSION The use of oropharyngeal colostrum immunotherapy can reduce the time for VLBW-PTNB to achieve full nutrition when compared to those who used a placebo or received routine care.

ABSTRACT OBJECTIVE To investigated the effect of oropharyngeal colostrum immunotherapy in reducing the time required for very low birth weight preterm newborns (VLBW-PTNB: < 1,500g and < 37 weeks) to achieve full enteral nutrition. METHODS Literature search was conducted using four databases, including gray literature, with additional manual search of the references of selected articles. Eligibility criteria consisted of randomized clinical trials, without restriction regarding the date or language of the publication. Two independent reviewers performed the article selection and data extraction. The random-effects meta-analysis used a non-standard technique to assess the mean difference in days to achieve full enteral nutrition, carried out by the Stata 15 statistic program. RESULTS The systematic review comprised 10 studies, and five were selected for meta-analysis, with a population of 764 VLBW-PTNB and gestational age of birth between 25 and 32 weeks. The studies were conducted between 2011 and 2018 in North America, Asia and Africa, with only one conducted in South America. Altogether, they reported the number of days it took 708 VLBW-PTNB to achieve full enteral nutrition, with newborns treated with immunotherapy showing a shorter time in only three studies. Meta-analysis showed a mean difference of -4.26 days, (95% CI -7.44; -1.08d), with high heterogeneity (I2 = 83.1%). CONCLUSION The use of oropharyngeal colostrum immunotherapy can reduce the time for VLBW-PTNB to achieve full nutrition when compared to those who used a placebo or received routine care.