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Erschienen in: Archives of Gynecology and Obstetrics 1/2018

11.10.2017 | Maternal-Fetal Medicine

No association between periodontitis and preterm low birth weight: a case–control study

verfasst von: Mariana Fampa Fogacci, Elaine de O. C. Cardoso, Davi da S. Barbirato, Denise Pires de Carvalho, Carmelo Sansone

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 1/2018

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Abstract

Purpose

This study aimed to investigate the association between periodontitis in pregnant women and adverse pregnancy outcomes by heeding confounding risk factors for preterm low birth weight infants.

Methods

This study was reported according to The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. A case–control study was conducted. Medical records of all pregnant women attending a prenatal care clinic were screened. Those between 21 and 34 years and gestational age of 28–32 weeks were initially enrolled in the study. The exclusion criteria were then applied: diabetes mellitus, genitourinary tract infections, or HIV infection; previous multiple gestations; previous preterm birth/low birth weight infants; in vitro fertilization procedures; placental, cervical/uterine abnormalities; history of infertility; history of drug abuse; and any medical conditions that required antibiotics prophylaxis. Patients’ anthropometric, demographic, and behavioral characteristics were collected. The periodontal clinical parameters were obtained from six sites per tooth: clinical attachment level, probing pocket depth, dental plaque index, and gingival bleeding index. Women were then allocated into two groups: mothers of preterm and/or low birth weight newborns (cases) and mothers of full-term and normal birth weight newborns (controls).

Results

Periodontal clinical parameters were analyzed and reported separately for each group, and no significant differences were observed (p > 0.05). Logistic regression analysis revealed that periodontal clinical parameters were not associated with the adverse pregnancy outcomes.

Conclusion(s)

After controlling for confounding factors, our results suggest that maternal periodontal disease is not a risk factor associated with preterm low birth weight infants.
Literatur
1.
Zurück zum Zitat Miller WD (1999) The Human mouth as a focus of infection. Dent Cosmos 1891:698–713 Miller WD (1999) The Human mouth as a focus of infection. Dent Cosmos 1891:698–713
3.
Zurück zum Zitat Johnson IH (1975) Effects of local irritation and dextran sulphate administration on the periodontium of the rat. J Periodontal Res 10:332–345CrossRefPubMed Johnson IH (1975) Effects of local irritation and dextran sulphate administration on the periodontium of the rat. J Periodontal Res 10:332–345CrossRefPubMed
4.
Zurück zum Zitat Kinane DF (1998) Periodontal diseases’ contributions to cardiovascular disease: an overview of potential mechanisms. Ann Periodontol 3:142–150CrossRefPubMed Kinane DF (1998) Periodontal diseases’ contributions to cardiovascular disease: an overview of potential mechanisms. Ann Periodontol 3:142–150CrossRefPubMed
5.
Zurück zum Zitat Allam E, Draz A, Hassan A, Neamat A, Galal M, Windsor LJ (2010) Expression of receptor activator of nuclear factor kappaB ligand in ligature-induced periodontitis in osteoporotic and non-osteoporotic rats. J Periodontal Res 45:136–142CrossRefPubMed Allam E, Draz A, Hassan A, Neamat A, Galal M, Windsor LJ (2010) Expression of receptor activator of nuclear factor kappaB ligand in ligature-induced periodontitis in osteoporotic and non-osteoporotic rats. J Periodontal Res 45:136–142CrossRefPubMed
6.
Zurück zum Zitat Keles GG, Acikgoz G, Ayas B, Sakallioglu E, Firatli E (2005) Determination of systemically & locally induced periodontal defects in rats. Indian J Med Res 121:176–184PubMed Keles GG, Acikgoz G, Ayas B, Sakallioglu E, Firatli E (2005) Determination of systemically & locally induced periodontal defects in rats. Indian J Med Res 121:176–184PubMed
7.
Zurück zum Zitat Rodrigues M, Barbirato D, Luiz RR, Scharfstein J, Salles GF, Feres-Filho EJ (2016) Effect of antihypertensive therapy with angiotensin-converting enzyme inhibitors on chronic periodontitis: a case–control study. Oral Dis 22:791–796CrossRefPubMed Rodrigues M, Barbirato D, Luiz RR, Scharfstein J, Salles GF, Feres-Filho EJ (2016) Effect of antihypertensive therapy with angiotensin-converting enzyme inhibitors on chronic periodontitis: a case–control study. Oral Dis 22:791–796CrossRefPubMed
8.
Zurück zum Zitat Galvão MP, Chapper A, Rösing CK, Ferreira MB, de Souza MA (2003) Methodological considerations on descriptive studies of induced periodontal diseases in rats. Pesqui Odontol Bras 17:56–62CrossRefPubMed Galvão MP, Chapper A, Rösing CK, Ferreira MB, de Souza MA (2003) Methodological considerations on descriptive studies of induced periodontal diseases in rats. Pesqui Odontol Bras 17:56–62CrossRefPubMed
9.
Zurück zum Zitat Leal AS, de Oliveira AE, Brito LM, Lopes FF, Rodrigues VP, Lima KF et al (2015) Association between chronic apical periodontitis and low-birth-weight preterm births. J Endod 41:353–357CrossRefPubMed Leal AS, de Oliveira AE, Brito LM, Lopes FF, Rodrigues VP, Lima KF et al (2015) Association between chronic apical periodontitis and low-birth-weight preterm births. J Endod 41:353–357CrossRefPubMed
10.
Zurück zum Zitat Sallay K, Sanavi F, Ring I, Pham P, Behling UH, Nowotny A (1982) Alveolar bone destruction in the immunosuppressed rat. J Periodontal Res 17:263–274CrossRefPubMed Sallay K, Sanavi F, Ring I, Pham P, Behling UH, Nowotny A (1982) Alveolar bone destruction in the immunosuppressed rat. J Periodontal Res 17:263–274CrossRefPubMed
11.
Zurück zum Zitat Liu YF, Wu LA, Wang J, Wen LY, Wang XJ (2010) Micro-computerized tomography analysis of alveolar bone loss in ligature- and nicotine-induced experimental periodontitis in rats. J Periodontal Res 45:714–719CrossRefPubMed Liu YF, Wu LA, Wang J, Wen LY, Wang XJ (2010) Micro-computerized tomography analysis of alveolar bone loss in ligature- and nicotine-induced experimental periodontitis in rats. J Periodontal Res 45:714–719CrossRefPubMed
12.
Zurück zum Zitat Fogacci MF, DaS Barbirato, CaS Amaral, da Silva PG, MeO Coelho, Bertozi G et al (2016) No association between periodontitis, preterm birth, or intrauterine growth restriction: experimental study in Wistar rats. Am J Obstet Gynecol 214:749.e711–749.e741CrossRef Fogacci MF, DaS Barbirato, CaS Amaral, da Silva PG, MeO Coelho, Bertozi G et al (2016) No association between periodontitis, preterm birth, or intrauterine growth restriction: experimental study in Wistar rats. Am J Obstet Gynecol 214:749.e711–749.e741CrossRef
13.
Zurück zum Zitat Abati S, Villa A, Cetin I, Dessole S, Lugliè PF, Strohmenger L et al (2013) Lack of association between maternal periodontal status and adverse pregnancy outcomes: a multicentric epidemiologic study. J Matern Fetal Neonatal Med 26:369–372CrossRefPubMed Abati S, Villa A, Cetin I, Dessole S, Lugliè PF, Strohmenger L et al (2013) Lack of association between maternal periodontal status and adverse pregnancy outcomes: a multicentric epidemiologic study. J Matern Fetal Neonatal Med 26:369–372CrossRefPubMed
14.
Zurück zum Zitat Collins JG, Windley HW, Arnold RR, Offenbacher S (1994) Effects of a Porphyromonas gingivalis infection on inflammatory mediator response and pregnancy outcome in hamsters. Infect Immun 62:4356–4361PubMedPubMedCentral Collins JG, Windley HW, Arnold RR, Offenbacher S (1994) Effects of a Porphyromonas gingivalis infection on inflammatory mediator response and pregnancy outcome in hamsters. Infect Immun 62:4356–4361PubMedPubMedCentral
16.
Zurück zum Zitat Bassani DG, Olinto MT, Kreiger N (2007) Periodontal disease and perinatal outcomes: a case–control study. J Clin Periodontol 34:31–39CrossRefPubMed Bassani DG, Olinto MT, Kreiger N (2007) Periodontal disease and perinatal outcomes: a case–control study. J Clin Periodontol 34:31–39CrossRefPubMed
17.
Zurück zum Zitat Gomes-Filho IS, Cruz SS, Rezende EJ, Dos Santos CA, Soledade KR, Magalhães MA et al (2007) Exposure measurement in the association between periodontal disease and prematurity/low birth weight. J Clin Periodontol 34:957–963CrossRefPubMed Gomes-Filho IS, Cruz SS, Rezende EJ, Dos Santos CA, Soledade KR, Magalhães MA et al (2007) Exposure measurement in the association between periodontal disease and prematurity/low birth weight. J Clin Periodontol 34:957–963CrossRefPubMed
18.
Zurück zum Zitat Siqueira FM, Cota LO, Costa JE, Haddad JP, Lana AM, Costa FO (2007) Intrauterine growth restriction, low birth weight, and preterm birth: adverse pregnancy outcomes and their association with maternal periodontitis. J Periodontol 78:2266–2276CrossRefPubMed Siqueira FM, Cota LO, Costa JE, Haddad JP, Lana AM, Costa FO (2007) Intrauterine growth restriction, low birth weight, and preterm birth: adverse pregnancy outcomes and their association with maternal periodontitis. J Periodontol 78:2266–2276CrossRefPubMed
19.
Zurück zum Zitat World Health Organization W (2016) International statistical classification of diseases and related health problems. World Health Organization, Geneva World Health Organization W (2016) International statistical classification of diseases and related health problems. World Health Organization, Geneva
21.
Zurück zum Zitat Corbella S, Taschieri S, Del Fabbro M, Francetti L, Weinstein R, Ferrazzi E (2016) Adverse pregnancy outcomes and periodontitis: a systematic review and meta-analysis exploring potential association. Quintessence Int 47:193–204PubMed Corbella S, Taschieri S, Del Fabbro M, Francetti L, Weinstein R, Ferrazzi E (2016) Adverse pregnancy outcomes and periodontitis: a systematic review and meta-analysis exploring potential association. Quintessence Int 47:193–204PubMed
22.
Zurück zum Zitat Ide M, Papapanou PN (2013) Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes—systematic review. J Clin Periodontol 40(Suppl 14):S181–S194PubMed Ide M, Papapanou PN (2013) Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes—systematic review. J Clin Periodontol 40(Suppl 14):S181–S194PubMed
23.
Zurück zum Zitat Macedo JF, Ribeiro RA, Machado FC, Assis NM, Alves RT, Oliveira AS et al (2014) Periodontal disease and oral health-related behavior as factors associated with preterm birth: a case–control study in south-eastern Brazil. J Periodontal Res 49:458–464CrossRefPubMed Macedo JF, Ribeiro RA, Machado FC, Assis NM, Alves RT, Oliveira AS et al (2014) Periodontal disease and oral health-related behavior as factors associated with preterm birth: a case–control study in south-eastern Brazil. J Periodontal Res 49:458–464CrossRefPubMed
24.
Zurück zum Zitat Piscoya MD, Ximenes RA, Silva GM, Jamelli SR, Coutinho SB (2012) Maternal periodontitis as a risk factor for prematurity. Pediatr Int 54:68–75CrossRefPubMed Piscoya MD, Ximenes RA, Silva GM, Jamelli SR, Coutinho SB (2012) Maternal periodontitis as a risk factor for prematurity. Pediatr Int 54:68–75CrossRefPubMed
25.
Zurück zum Zitat Vettore MV, Leal M, Leão AT, da Silva AM, Lamarca GA, Sheiham A (2008) The relationship between periodontitis and preterm low birthweight. J Dent Res 87:73–78CrossRefPubMed Vettore MV, Leal M, Leão AT, da Silva AM, Lamarca GA, Sheiham A (2008) The relationship between periodontitis and preterm low birthweight. J Dent Res 87:73–78CrossRefPubMed
26.
Zurück zum Zitat Michalowicz BS, Hodges JS, DiAngelis AJ, Lupo VR, Novak MJ, Ferguson JE et al (2006) Treatment of periodontal disease and the risk of preterm birth. N Engl J Med 355:1885–1894CrossRefPubMed Michalowicz BS, Hodges JS, DiAngelis AJ, Lupo VR, Novak MJ, Ferguson JE et al (2006) Treatment of periodontal disease and the risk of preterm birth. N Engl J Med 355:1885–1894CrossRefPubMed
27.
Zurück zum Zitat Lin D, Smith MA, Champagne C, Elter J, Beck J, Offenbacher S (2003) Porphyromonas gingivalis infection during pregnancy increases maternal tumor necrosis factor alpha, suppresses maternal interleukin-10, and enhances fetal growth restriction and resorption in mice. Infect Immun 71:5156–5162CrossRefPubMedPubMedCentral Lin D, Smith MA, Champagne C, Elter J, Beck J, Offenbacher S (2003) Porphyromonas gingivalis infection during pregnancy increases maternal tumor necrosis factor alpha, suppresses maternal interleukin-10, and enhances fetal growth restriction and resorption in mice. Infect Immun 71:5156–5162CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Yeo A, Smith MA, Lin D, Riché EL, Moore A, Elter J et al (2005) Campylobacter rectus mediates growth restriction in pregnant mice. J Periodontol 76:551–557CrossRefPubMed Yeo A, Smith MA, Lin D, Riché EL, Moore A, Elter J et al (2005) Campylobacter rectus mediates growth restriction in pregnant mice. J Periodontol 76:551–557CrossRefPubMed
29.
Zurück zum Zitat Liu H, Redline RW, Han YW (2007) Fusobacterium nucleatum induces fetal death in mice via stimulation of TLR4-mediated placental inflammatory response. J Immunol 179:2501–2508CrossRefPubMed Liu H, Redline RW, Han YW (2007) Fusobacterium nucleatum induces fetal death in mice via stimulation of TLR4-mediated placental inflammatory response. J Immunol 179:2501–2508CrossRefPubMed
30.
Zurück zum Zitat Han YW, Redline RW, Li M, Yin L, Hill GB, McCormick TS (2004) Fusobacterium nucleatum induces premature and term stillbirths in pregnant mice: implication of oral bacteria in preterm birth. Infect Immun 72:2272–2279CrossRefPubMedPubMedCentral Han YW, Redline RW, Li M, Yin L, Hill GB, McCormick TS (2004) Fusobacterium nucleatum induces premature and term stillbirths in pregnant mice: implication of oral bacteria in preterm birth. Infect Immun 72:2272–2279CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Newnham JP, Shub A, Jobe AH, Bird PS, Ikegami M, Nitsos I et al (2005) The effects of intra-amniotic injection of periodontopathic lipopolysaccharides in sheep. Am J Obstet Gynecol 193:313–321CrossRefPubMed Newnham JP, Shub A, Jobe AH, Bird PS, Ikegami M, Nitsos I et al (2005) The effects of intra-amniotic injection of periodontopathic lipopolysaccharides in sheep. Am J Obstet Gynecol 193:313–321CrossRefPubMed
32.
Zurück zum Zitat Galvão MP, Rösing CK, Ferreira MB (2003) Effects of ligature-induced periodontitis in pregnant Wistar rats. Pesqui Odontol Bras 17:51–55CrossRefPubMed Galvão MP, Rösing CK, Ferreira MB (2003) Effects of ligature-induced periodontitis in pregnant Wistar rats. Pesqui Odontol Bras 17:51–55CrossRefPubMed
33.
Zurück zum Zitat Xiong X, Buekens P, Vastardis S, Yu SM (2007) Periodontal disease and pregnancy outcomes: state-of-the-science. Obstet Gynecol Surv 62:605–615CrossRefPubMed Xiong X, Buekens P, Vastardis S, Yu SM (2007) Periodontal disease and pregnancy outcomes: state-of-the-science. Obstet Gynecol Surv 62:605–615CrossRefPubMed
34.
Zurück zum Zitat Vettore MV, Lamarca GeA, Leão AT, Thomaz FB, Sheiham A, Leal MoC (2006) Periodontal infection and adverse pregnancy outcomes: a systematic review of epidemiological studies. Cad Saude Publica 22:2041–2053CrossRefPubMed Vettore MV, Lamarca GeA, Leão AT, Thomaz FB, Sheiham A, Leal MoC (2006) Periodontal infection and adverse pregnancy outcomes: a systematic review of epidemiological studies. Cad Saude Publica 22:2041–2053CrossRefPubMed
35.
Zurück zum Zitat Kramer MS (1987) Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ 65:663–737PubMedPubMedCentral Kramer MS (1987) Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ 65:663–737PubMedPubMedCentral
36.
Zurück zum Zitat Carter DH, Sloan P, Aaron JE (1994) The cryomicrotomy of rat dental tissues: a technique for histological and immunohistochemical analysis. Histochem J 26:103–109CrossRefPubMed Carter DH, Sloan P, Aaron JE (1994) The cryomicrotomy of rat dental tissues: a technique for histological and immunohistochemical analysis. Histochem J 26:103–109CrossRefPubMed
37.
Zurück zum Zitat Borrell LN, Papapanou PN (2005) Analytical epidemiology of periodontitis. J Clin Periodontol 32(Suppl 6):132–158CrossRefPubMed Borrell LN, Papapanou PN (2005) Analytical epidemiology of periodontitis. J Clin Periodontol 32(Suppl 6):132–158CrossRefPubMed
38.
Zurück zum Zitat Page RC, Kornman KS (2000) The pathogenesis of human periodontitis: an introduction. Periodontology 1997(14):9–11 Page RC, Kornman KS (2000) The pathogenesis of human periodontitis: an introduction. Periodontology 1997(14):9–11
39.
Zurück zum Zitat Garant PR, Paik KS, Cho MI (1983) The distribution of plasma cells in naturally occurring periodontitis lesions in rats. A light and electron microscopic study. J Periodontol 54:227–235CrossRefPubMed Garant PR, Paik KS, Cho MI (1983) The distribution of plasma cells in naturally occurring periodontitis lesions in rats. A light and electron microscopic study. J Periodontol 54:227–235CrossRefPubMed
40.
Zurück zum Zitat Martínez-Martínez RE, Moreno-Castillo DF, Loyola-Rodríguez JP, Sánchez-Medrano AG, Miguel-Hernández JH, Olvera-Delgado JH et al (2016) Association between periodontitis, periodontopathogens and preterm birth: is it real? Arch Gynecol Obstet 294:47–54CrossRefPubMed Martínez-Martínez RE, Moreno-Castillo DF, Loyola-Rodríguez JP, Sánchez-Medrano AG, Miguel-Hernández JH, Olvera-Delgado JH et al (2016) Association between periodontitis, periodontopathogens and preterm birth: is it real? Arch Gynecol Obstet 294:47–54CrossRefPubMed
41.
Zurück zum Zitat von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP et al (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med 147:573–577CrossRef von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP et al (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med 147:573–577CrossRef
42.
Zurück zum Zitat Institute of Medicine (US), National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines, Rasmussen KM, Yaktine AL (2009) Weight gain during pregnancy: reexamining the guidelines. National Academies Press, Washington (DC) Institute of Medicine (US), National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines, Rasmussen KM, Yaktine AL (2009) Weight gain during pregnancy: reexamining the guidelines. National Academies Press, Washington (DC)
43.
Zurück zum Zitat Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G et al (1996) Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 67:1103–1113CrossRefPubMed Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G et al (1996) Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 67:1103–1113CrossRefPubMed
44.
Zurück zum Zitat Carlos JP, Wolfe MD, Kingman A (1986) The extent and severity index: a simple method for use in epidemiologic studies of periodontal disease. J Clin Periodontol 13:500–505CrossRefPubMed Carlos JP, Wolfe MD, Kingman A (1986) The extent and severity index: a simple method for use in epidemiologic studies of periodontal disease. J Clin Periodontol 13:500–505CrossRefPubMed
45.
Zurück zum Zitat Gynecologists ACoOa (2013) ACOG practice bulletin no. 134: fetal growth restriction. Obstet Gynecol 121:1122–1133CrossRef Gynecologists ACoOa (2013) ACOG practice bulletin no. 134: fetal growth restriction. Obstet Gynecol 121:1122–1133CrossRef
46.
Zurück zum Zitat Figueras F, Gardosi J (2011) Intrauterine growth restriction: new concepts in antenatal surveillance, diagnosis, and management. Am J Obstet Gynecol 204:288–300CrossRefPubMed Figueras F, Gardosi J (2011) Intrauterine growth restriction: new concepts in antenatal surveillance, diagnosis, and management. Am J Obstet Gynecol 204:288–300CrossRefPubMed
47.
Zurück zum Zitat Coonrod DV, Jack BW, Stubblefield PG, Hollier LM, Boggess KA, Cefalo R et al (2008) The clinical content of preconception care: infectious diseases in preconception care. Am J Obstet Gynecol 199:S296–S309CrossRefPubMed Coonrod DV, Jack BW, Stubblefield PG, Hollier LM, Boggess KA, Cefalo R et al (2008) The clinical content of preconception care: infectious diseases in preconception care. Am J Obstet Gynecol 199:S296–S309CrossRefPubMed
48.
Zurück zum Zitat Hsieh VC-R, Yang Y-H, Liou S-H, Li C-Y, Wu T-N (2014) Influence of socioeconomic status on the association between prenatal periodontal care and preterm low birthweight delivery: a population-based case–control study. J Res Pract Dent 2014:1–15 Hsieh VC-R, Yang Y-H, Liou S-H, Li C-Y, Wu T-N (2014) Influence of socioeconomic status on the association between prenatal periodontal care and preterm low birthweight delivery: a population-based case–control study. J Res Pract Dent 2014:1–15
49.
Zurück zum Zitat Lengyel CS, Ehrlich S, Iams JD, Muglia LJ, DeFranco EA (2016) Effect of modifiable risk factors on preterm birth: a population based-cohort. Matern Child Health J 21(4):777–785CrossRef Lengyel CS, Ehrlich S, Iams JD, Muglia LJ, DeFranco EA (2016) Effect of modifiable risk factors on preterm birth: a population based-cohort. Matern Child Health J 21(4):777–785CrossRef
50.
Zurück zum Zitat Bucal BMdSSdAàSDdABCNdS (2011) Projeto SB Brasil 2010: condições de saúde bucal da população brasileira—resultados principais. Editor MS, 2004 Bucal BMdSSdAàSDdABCNdS (2011) Projeto SB Brasil 2010: condições de saúde bucal da população brasileira—resultados principais. ​Editor MS, 2004
51.
Zurück zum Zitat Jin LJ, Lamster IB, Greenspan JS, Pitts NB, Scully C, Warnakulasuriya S (2015) Global burden of oral diseases: emerging concepts, management and interplay with systemic health. Oral Dis 22(7):609–619CrossRef Jin LJ, Lamster IB, Greenspan JS, Pitts NB, Scully C, Warnakulasuriya S (2015) Global burden of oral diseases: emerging concepts, management and interplay with systemic health. Oral Dis 22(7):609–619CrossRef
Metadaten
Titel
No association between periodontitis and preterm low birth weight: a case–control study
verfasst von
Mariana Fampa Fogacci
Elaine de O. C. Cardoso
Davi da S. Barbirato
Denise Pires de Carvalho
Carmelo Sansone
Publikationsdatum
11.10.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 1/2018
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-017-4556-9

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