INTRODUCTION: Although the association between periodontal disease (PD) and adverse pregnancy
outcomes has gained recognition amongst antenatal healthcare workers, not much has changed in
practice to address it. This prospective study tested the hypothesis that BANA (N-benzoyl-DL-arginine-
2-naphthylamide), a diagnostic test for PD, may inform obstetricians and other antenatal healthcare
practitioners, of the risk of adverse pregnancy outcomes in mothers attending antenatal clinics.
METHODS: At first visit, the presence of suspected periodontopathogens was assessed by BANA testing
of dental plaque from 443 mothers attending antenatal clinics in KwaZulu-Natal, South Africa and an
association later sought with pregnancy outcomes. The accuracy of BANA to predict adverse pregnancy
outcomes was evaluated by the calculation of likelihood ratios. The study complied with the
Declaration of Helsinki.
RESULTS: Significant differences were found between pregnancy outcomes of BANA-negative and
BANA-positive mothers (p<0.0001). BANA showed sensitivity and negative predictive values of 87%
and 91%; 75% and 78%; 87% and 94% in detecting low birth weight, preterm delivery, and preterm
low birth weight delivery respectively.
CONCLUSION: This study confirms that BANA may indicate the need for periodontal therapy to reduce
the risk of adverse pregnancy outcomes and could form part of the routine antenatal examination.