Abstract
Introduction: Periodontal disease (PD) represents several pathological changes that occur in the periodontium, that is, the tissues surrounding the teeth. These include the periodontal ligament, cementum, alveolar bone, and gingiva. During pregnancy, women enter a period in which oral health should be a priority. During this period, estrogen and progesterone levels, their sex hormones, potentially increase over time and are detrimental to tissue metabolism. Objective: It was to conduct a systematic review of the risk of periodontal disease in pregnant women. Methods: The research was conducted from June to July 2026 in the Scopus, Embase, PubMed, Science Direct, and Scielo databases, using older gold-standard scientific articles up to 2025. Study quality was based on the GRADE instrument, and risk of bias was assessed using the Cochrane tool. Results and Conclusion: A total of 145 studies were found and submitted to eligibility analysis. The final sample contained 17 eligible studies, which were described in the systematic review. Most studies presented homogeneous results, with X2=70.5% >50%. This study highlighted that periodontal disease in pregnant women may be one of the determinants of low birth weight. Studies were conducted to verify the existence of an association between maternal periodontal disease and low birth weight. The gestational period is when the occurrence of PD is more likely due to its hormonal and physiological changes. Pregnant women should be vigilant and take appropriate care, have prenatal care with their dentist, and in addition to oral care, they should be aware of the risks of low birth weight and preterm birth. Infections in the genitourinary tract, such as PD, may be associated with the occurrence of low birth weight newborns through the same mechanisms as other maternal infections and preterm birth. Uterine contraction and cervical dilation, which trigger premature birth, can be caused by inflammatory stimuli, which can induce hyperirritability of the uterine smooth muscle. Infection and the resulting inflammatory process can damage the placenta, thus restricting fetal development. Throughout life, women experience various phases of hormonal fluctuations that, in addition to interfering with the reproductive system, influence other organs and systems, such as the periodontium, especially in the presence of preexisting plaque-induced gingival inflammation. During pregnancy, women are exposed to several significant hormonal changes, as the placenta produces high amounts of estrogen and progesterone, which, in turn, affect oral tissues. It was concluded that Black women over 40 are more likely to have PD, presenting a higher risk of poor fetal development.