  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.
