New research shows that chewing sugar-free gum reduces premature births

Each year an estimated 15 million babies are born prematurely or prematurely (defined as being born before age 37).th week of pregnancy), and this number is increasing according to the World Health Organization. Premature babies are at higher risk of serious health problems.

Over the past few decades, several studies have shown a link between poor oral health and an increased incidence of preterm birth. Researchers have studied several ways to improve dental health during pregnancy, including a “deep tooth cleaning” (also called “scaling and planing”), which removes plaque and tartar on the teeth and below the gumline. However, despite improvement in periodontitis, approaches to deep cleaning the teeth have not proven effective in preventing preterm birth. But now researchers have discovered a simple and inexpensive way to improve oral health and reduce preterm birth.

In a new study presented today at the Society for Maternal-Fetal Medicine (SMFM) annual meeting, The Pregnancy Meeting™, which will be held virtually, researchers will reveal the results indicate that the daily intake of xylitol chewing gum from pre or early pregnancy significantly reduces the number of preterm births. Xylitol is a naturally occurring alcohol found in fruits and vegetables and is commonly used as a sugar substitute in chewing gum.

The study, the largest of its kind, was conducted over 10 years and included 10,069 women in the south-central African country of Malawi, which has the highest rate of preterm births in the world. Most Malawians live in rural areas, which makes conducting studies of this scale particularly difficult.

The cluster-randomized study included participants from eight health centers in Malawi and was approved by the Malawi Ministry of Health. Participants volunteered and consented to participate before becoming pregnant or within 20 weeks of pregnancy. All eight health centers offered health messages to promote oral health and preterm birth prevention and care, while half of the eight centers were randomized to also provide xylitol gum to enrolled research participants.

At the four health centers that served as controls, 5,520 participants received basic perinatal and oral health education, including things they can do to reduce the chances of preterm birth. At the other four centers, the 4,549 enrolled participants also received the same health education. In addition, they were given xylitol gum and instructed to chew the gum once a day, ideally twice a day, for 10 minutes throughout the pregnancy.

Of the 9,670 participants who were available for contact during up to six years of follow-up, the results showed a significant reduction in preterm births in those who chewed the xylitol-containing gum (12.6 percent versus 16.5 percent) and fewer low-birth-weight babies who weigh 5.5 pounds or less (8.9 percent vs. 12.9 percent). Participants also saw an improvement in their oral health.

“The use of xylitol chewing gum as an intervention before 20 weeks’ gestation reduced preterm births and particularly late preterm births between 34 and 37 weeks,” says lead author of the study Kjersti Aagaard, MD, PhD, professor of maternal-fetal medicine and vice chair for Obstetrics and Gynecology at Texas Children’s and Baylor College of Medicine in Houston. “When we analyzed by birth weight rather than estimated gestational age at birth, we also showed a significant improvement in birth weight, with a third fewer low birth weight babies being born.”

Aagaard adds: “What is unique about our study is that we used a readily available, inexpensive and palatable means to reduce the risk of a baby being born prematurely or small. There is some real science behind choosing xylitol gum to improve oral health, and our novel use in improving childbirth outcomes is exciting. This was a labor of love with our colleagues in Malawi and we were honored to work side by side to show that xylitol chewing gum in early or pre-pregnancy improves oral health by reducing the strongly associated periodontitis in of pregnancy reduced with our observed reduction in preterm and low birth weight births in Malawi. This fits with long-standing evidence linking oral health to preterm birth.”

The next step, the researchers say, is to conduct studies in other parts of the world, including the United States, to determine if this invention is effective in settings that may have a lower oral health-related burden of preterm birth .

The abstract was published in the January 2022 Supplement American Journal of Obstetrics and Gynecology (AJOG) and can be accessed free of charge at the AJOG website. To view the presentation of this abstract or other Pregnancy Meeting™ abstracts and events, visit the SMFM website or contact Karen Addis at [email protected] or 301-787-2394.

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