Xylitol chewing gum reduced preterm birth in research

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Simple and inexpensive—xylitol chewing gum reduced preterm births in research


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A study conducted in Malawi—the country with the highest preterm birth rate in the world—has investigated whether chewing xylitol gum would improve the periodontal health of pregnant women and thereby lead to a decrease in premature deliveries. (Image: Kristina Bessolova/Shutterstock)

HOUSTON, US/LILONGWE, Malawi: Studies have shown a link between maternal periodontal disease and preterm birth—delivery before the 37th week of pregnancy. However, scaling and root planing in pregnant women have not been shown in randomised trials to be successful in preventing preterm birth, despite improving periodontitis. A recent multicentre randomised controlled trial by researchers in the US and Malawi has investigated a different intervention: chewing gum containing xylitol, which is known for reducing caries. It found that daily usage of the gum before or in early pregnancy significantly reduced the number of preterm births.

The study, the largest of its kind, included 9,670 women from eight healthcare centres in Malawi—the country with the highest known preterm birth rate (18.1 per 100 births)—and was conducted over six years. All of the eight health centres provided the participants with perinatal and oral health education and four of the health centres additionally administered the daily use of xylitol chewing gum.

The research team found that the daily intake of xylitol gum significantly reduced the risk of preterm birth (12.6% compared with 16.5% in the control group) and hence reduced the likelihood of birthweight of less than 2.5 kg (8.9% compared with 12.9%).

Xylitol is a sugar alcohol that occurs naturally in fruits and vegetables and is commonly used as a food additive and sugar substitute. (Image: Danijela Maksimovic/Shutterstock)

“Using xylitol chewing gum as an intervention prior to 20 weeks of pregnancy reduced preterm births, and specifically late preterm births between 34 to 37 weeks,” commented lead author Dr Kjersti Aagaard, Henry and Emma Meyer chair in obstetrics and gynaecology at Texas Children’s Hospital and Baylor College of Medicine in Houston, in a press release.

She added: “What’s unique about our study is that we used a readily available, inexpensive, and palatable means to reduce the risk of a baby being born too soon or too small. There is some real science behind the choice of xylitol chewing gum to improve oral health, and our novel application to improving birth outcomes is exciting.”

According to Dr Aagaard, the results are consistent with longstanding evidence linking oral health status to preterm birth. In the future, the researchers would like to conduct similar studies in other parts of the world, including in the US, to find out whether the study results can be reproduced in settings where there may be a lower burden of preterm birth tied to oral health.

Around 15 million babies, which is more than one in ten births, are born prematurely each year, according to the World Health Organization. Preterm babies are of higher risk of dying shortly after birth or of suffering from lifelong health problems.

The study was presented at this year’s annual meeting of the Society for Maternal-Fetal Medicine. The study abstract, titled “LB 1: PPaX: Cluster randomized trial of xylitol chewing gum on prevention of preterm birth in Malawi”, was published online in the January 2022 supplement of the American Journal of Obstetrics and Gynecology.

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