Sugar-Free Gum May Reduce Preterm Birth Rates: Study

A large-scale study in Africa found a 30 percent reduction in very-low-birth-weight babies born to pregnant women who chewed xylitol-sweetened gum.

Shutterstock

Chewing xylitol gum may be able to prevent preterm birth.

A three-year study of more than 10,000 pregnant women in Malawi, a country in southeastern Africa, found that pregnant women who chewed sugar-free, xylitol-sweetened gum had a 24 percent reduction in the incidence of preterm birth compared to women who did not.

Xylitol is a sugar-free sweetener derived from xylose, which can be extracted from birch trees and corn cobs. Preterm birth occurs when a baby is born before 37 weeks of pregnancy.

“It surprised us all that such a simple intervention could have such a dramatic effect,” Dr. Greg Valentine, associate professor of pediatrics at the University of Washington School of Medicine and lead study author, said in a press statement.

Xylitol Linked to About 30 Percent Fewer Preterm Births

The findings, published Wednesday in Med, a journal by Cell Press, suggest a potentially simple solution for a serious health challenge in the region.

The study, conducted from May 2015 to October 2018, followed more than 10,000 participants from eight health centers across Malawi. Researchers randomly assigned 4,549 pregnant women to receive xylitol-containing gum, while 5,520 in the control group received standard counseling.

Those who received the xylitol-gum intervention experienced a 30 percent drop in the delivery of very-low-birth-weight babies and a 24 percent reduction in babies born before 37 weeks compared to the control group, said Dr. Kjersti Aagaard, medical director of HCA Healthcare, who began the study at the Baylor College of Medicine.

Low-birth-weight babies are those born weighing under 5 pounds, 8 ounces. Babies under 3 pounds, 4 ounces are considered very-low-birth-weight.

Gum Disease Linked to Preterm Birth

Previous research has established that periodontal disease, or gum disease, caused by a buildup of plaque that forms on the teeth, increases the risk of preterm birth and low-birth-weight deliveries by two to three times.

While the specific mechanism behind this link remains unclear, it may involve the inflammatory response related to periodontal disease or the spread of bacteria from the mouth to other organs.

“Basically, we know that periodontal disease is associated with preterm birth,” Valentine said in the press release. “This is particularly significant in Malawi, since about 70% of the pregnant individuals suffer from gum disease.” Malawi has one of the highest rates of preterm birth worldwide, with such births occurring in up to 20 percent of pregnancies.

How Xylitol Works Beyond Cavity Prevention

The researchers pointed out that xylitol has probiotic properties and can reduce the growth of bacteria linked to periodontal disease and inflammation in gum tissues.

The participants in the trial chewed xylitol gum from early pregnancy until delivery, which, according to researchers, helped improve oral health more accessibly than traditional methods, which can be difficult to implement in low-resource settings.

The findings are specific to Malawi and have not been shown to apply to other regions. “We do need to confirm the findings in the United States and other settings before that is a generalized statement that’s made up throughout the world,” Valentine told The Epoch Times.

Studies that looked at traditional treatments, “where you basically pull out the plaque from the teeth,” don’t show that this method prevents preterm birth, he said. In fact, removing plaque in this manner might actually increase inflammation in pregnancy, according to Valentine. However, “[plaque removal has] not been shown to be harmful. It definitely is not harmful. It improves oral health, but it may not be the best method to prevent preterm birth.”

Future Research Plans

Valentine is leading a follow-up study in Malawi called the Prevention of Developmental Delay and Xylitol study. This research will track neurodevelopmental outcomes in 1,000 children born during the initial trial, with results expected in 2027.

The researchers also plan to test the xylitol-gum intervention in lower-resourced communities in the Seattle area.

“This finding could pave the way for a simple intervention such as xylitol chewing gum to improve both pregnancy and newborn outcomes,” Valentine said. “That’s why further studies are needed to investigate how the effects are in the United States population to confirm those findings.”

Valentine cautions that high xylitol intake—30 grams or more per day—can cause gastrointestinal issues, including diarrhea, upset stomach, and bloating.

“It would not be good to take high quantities of xylitol.”