Evaluation of Microflora (Viral and Bacterial) in Subgingival and Placental Samples of Pregnant Women with Preeclampsia with and without Periodontal Disease: A Cross-Sectional Study

Abstract

A BSTRACT Aim: Previous studies showed associated periodontal disease with various systemic ailments. This research work was aimed at studying the presence and role of periodontal microflora on preeclampsia during pregnancy. Materials and Methods: A cross-sectional study was designed on pregnant women with preeclampsia with and without chronic periodontitis, attending Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India, for prenatal checkups. After obtaining consents, 445 women were recruited in the study. On the basis of systemic and periodontal health, subjects were grouped into Group 1 (women with preeclampsia with chronic periodontitis) and Group 2 (women with preeclampsia without chronic periodontitis). Clinical parameters such as plaque index, bleeding on probing, probing depth, and clinical attachment level were recorded. Quantification of periodontopathic bacteria ( Porphyromonas gingivalis , Fusobacterium nucleatum , Prevotella intermedia , Tannerella forsythia , Treponema denticola ), Epstein–Barr virus (EBV), cytomegalovirus (CMV), and herpes simplex virus (HSV), were detected using real-time polymerase chain reaction in subgingival samples at one point of time and later compared in placental tissue after parturition. Results: T. forsythia , T. denticola , F. nucleatum , P. intermedia , EBV, CMV, and HSV were expressed more in Group 3 compared to those in Groups 2, 4, and 1, in their subgingival and placental samples. Conclusion: Elevated levels of bacteria and viruses were expressed in subgingival and placental samples in women with preeclampsia with chronic periodontitis compared to those in women with preeclampsia without chronic periodontitis. This shows that chronic periodontitis is a risk factor for preeclampsia. The results concluded that periodontal flora is not only localized to periodontal tissues but can also enter uterine cavity and may elicit their pathological response on mother and developing fetus.

Oral microflora and pregnancy: a systematic review and meta-analysis

“…org). www.nature.com/scientificreports/ pregnancy and adverse birth outcome in Table 4 [21][22][23][24][25][63][64][65][66][67][68][69][70][71][72][73] ; eight studies on impact of periodontal disease on oral microorganisms during pregnancy in Table 5 [74][75][76][77][78][79][80][81] ; six studies on impact of gestational diabetes mellitus (GDM) on oral microorganisms during pregnancy in Table 6 [82][83][84][85][86][87] ; 11 studies on impact of systemic health conditions on oral microorganisms during pregnancy in Table 7 [88][89][90][91][92][93][94][95][96][97][98] . Quality and risk of bias for randomized controlled trials was assessed and are shown in Fig.…”

“…www.nature.com/scientificreports/ Pre-eclampsia. Two studies 88,89 performed in Colombia and three studies 81,94,95 performed in India revealed the influence of pre-eclampsia on the levels of the oral microbiome. Specifically, the birth weight of newborns were significantly lower in women with pre-eclampsia (p < 0.001) 88 .…”

Fusobacterium nucleatum and Prevotella in women with periodontitis and preterm birth

“…Case-control studies have associated the presence of oral pathogens, including Fn and Pi, with hypertensive disorders during pregnancy, as they have been shown to have higher levels in hypertensive women than in normotensive patient groups ( 9 , 17 ). In the present study, it was found that there were more hypertensive mothers among the case group participants, a situation that corroborates the literature on the birth of premature and/or low birth weight babies ( 8 ).…”

“…In the present study, it was found that there were more hypertensive mothers among the case group participants, a situation that corroborates the literature on the birth of premature and/or low birth weight babies ( 8 ). In addition, high levels of bacteria and viruses in the subgingival and placental samples occur more in women with preeclampsia and periodontitis compared to women with preeclampsia and without periodontitis ( 17 ).…”