Gingival crevicular fluid prostaglandin E2 level as a predictor of preterm low birth weight: a pilot investigation

Abstract

Periodontal infections, which serveas a reservoir of inflammatory mediators such as prostaglandin E 2 (PGE 2 ), may pose a threat to the fetal-placental unit and cause preterm delivery. This study was conducted to estimate the levels of PGE 2 in gingival crevicular fluid (GCF) and serum to explore the possible use of the GCF-PGE 2 level as a risk predictor of preterm low birth weight (PLBW). Twenty-two pregnant female patients were selected for the study. Samples of GCF and serum were collected from each patient, and sampling was repeated at one month after parturition. The level of PGE 2 in GCF and serum was estimated using a commercially available ELISA kit (NeogenTM). The mean serum PGE 2 level was 4.4 ng/ml and 1.64 ng/ml before and after parturition, respectively, and the difference was statistically significant (P < 0.001). The mean GCF-PGE 2 level was 5.8 ng/ml and 5.5 ng/ml before and after parturition, respectively, but the difference was not significant. There was positive correlation between the serum-PGE 2 and GCF-PGE 2 levels, and there was a negative correlation between PGE 2 level and gestational age. The present findings suggest that there is a weak correlation between maternal GCF-PGE 2 level and birth outcome. Further clinical trials with a larger sample size are warranted for further investigation of the association between GCF-PGE 2 level and PLBW. (J Oral Sci 53, 293-300, 2011)

Manejo odontológico de la paciente embarazada

“…Asimismo, las endotoxinas bacterianas activan el sistema inmunológico del hospedero liberando mediadores inflamatorios, como prostaglandinas, interleuquinas y factor de necrosis tumoral, entre otras citoquinas. Estas sustancias generan la destrucción del ligamento periodontal y el hueso alveolar, lo que causa la pérdida del sistema de soporte dental y a futuro, si la paciente no recibe un tratamiento adecuado, podría perder piezas dentales [19,20,21,22]; lo que tal vez hace eco de ese refrán popular, que dice: "un embarazo, un dien ser real si no existe el consabido tratamiento enfermedad periodontal.…”

“…Otros datos científicos que son importantes a considerar en este contexto, es la propuesta de que esos mediadores inflamatorios generados en la enfermedad periodontal activan anticipadamente las contracciones uterinas y la dilatación cervical [19,20,21,22,23]; por lo que se relacionan como un factor de riesgo para sufrir un parto de pretérmino, esto es, antes de las 37 semanas de gestación, o bien, aument bajo peso al nacer (menos de 2500g) [20,23]. Estas situaciones generan complicaciones que incrementan la morbilidad y la mortalidad infantil, acarreando un alto coste hospitalario y una problemática psicológica en el seno familiar [22].…”

“…Estas situaciones generan complicaciones que incrementan la morbilidad y la mortalidad infantil, acarreando un alto coste hospitalario y una problemática psicológica en el seno familiar [22].…”

Inflammation Mediators Related to Periodontal Disease and Pregnancy Outcomes: A Call for Quality of Antenatal Care While Promising Evidences Are Emerging

“…Offenbacher et al (1998) analyzed the relationship between PGE2 level in the gingival crevicular fluid (GCF) and delivery outcomes and demonstrated that several periodontal pathogens as well as PGE2 were found in higher levels in women with preterm delivery. Tarannum et al (2011) showed that the mean serum PGE2 level was higher in mothers of preterm birth infants than in mothers of full-term birth infants, and was also higher in mothers of low-birth-weight infants than in mothers of normal-birth-weight infants. Their results also showed that the mean level of PGE2 in GCF was higher in mothers of low-birth-weight infants than in mothers of normal-birth-weight infants, and was higher in mothers of preterm birth infants than in mothers of full-term birth infants.…”

“…Current understanding of the biological events surrounding normal labor and preterm labor strongly suggests that prostaglandins play a pivotal role in the initiation process (Tarannum, Faizuddin, & Madaiah, 2011). Some reports have suggested that periodontal infections, which serve as a reservoir of inflammatory mediators such as PGE2, may pose a threat to the fetal-placental unit.…”