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Objectives: A conflicting body of evidence suggests localized periodontal inflammation to spread systemically during pregnancy inducing adverse pregnancy outcomes. This systematic review and meta-analysis aimed to specifically evaluate the relationship between periodontitis and preeclampsia. Methods: Electronic searches were carried out in Medline, Pubmed, Cochrane Controlled Clinical Trial Register to identify and select observational case-control and cohort studies that analyzed the association between periodontal disease and preeclampsia. Prisma guidelines and Moose checklist were followed. Results: Thirty studies including six cohorts and twenty-four case-control studies were selected. Periodontitis was significantly associated with increased risk for preeclampsia, especially in a subgroup analysis including cohort studies and subgroup analysis with lower-middle-income countries. Conclusion: Periodontitis appears as a significant risk factor for preeclampsia, which might be even more pronounced in lower-middle-income countries.
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