Periodontal disease and some adverse perinatal outcomes in a cohort of low risk pregnant women

Abstract

ObjectiveTo evaluate the association of periodontal disease (PD) in pregnancy with some adverse perinatal outcomes.MethodThis cohort study included 327 pregnant women divided in groups with or without PD. Indexes of plaque and gingival bleeding on probing, probing pocket depth, clinical attachment level and gingival recession were evaluated at one periodontal examination below 32 weeks of gestation. The rates of preterm birth (PTB), low birth weight (LBW), small for gestational age (SGA) neonates and prelabor rupture of membranes (PROM) were evaluated using Risk Ratios (95%CI) and Population Attributable Risk Fractions.ResultsPD was associated with a higher risk of PTB (RRadj. 3.47 95%CI 1.62-7.43), LBW (RRadj. 2.93 95%CI 1.36-6.34) and PROM (RRadj. 2.48 95%CI 1.35-4.56), but not with SGA neonates (RR 2.38 95%CI 0.93 - 6.10).ConclusionsPD was a risk factor for PT, LBW and PROM among Brazilian low risk pregnant women.

Oral colonization of Gram-negative anaerobes as a risk factor for preterm delivery

“…There are several risk factors associated with adverse pregnancy outcomes, including prenatal care, [12][13][14] 39,40 and infection and inflammation. [41][42][43] Recently, a genetic predisposition for PTB has been proposed, either due to racial disparities that are independent of socio-economic factors, 25 or as part of the gene-environmental interaction associated with either hypo-or hyper-immune responses.…”

The Association between Periodontal Disease and Preterm Low Birthweight in Kosovo

“…Naše istraživanje uključiva-lo je ispitanice bijele rase, pa zbog demografskih ograničenja nismo mogli odrediti razlike ovisne o rasi. U istraživanju u kojem je sudjelovalo 327 Brazilki niskoga trudničkoga rizika s PB-om ili bez njega, zaključeno je da je PB rizičan čimbenik za PPNT i prijevremeno pucanje membrane (24).…”

Adverse Pregnancy Outcomes and Maternal Periodontal Health

“…[13][14][15]29,[31][32][33] Eventually, the bacteria, virulence factors, and inflammatory cytokines reach the placenta and create a new bacterial infection, initiating a new inflammatory response at the fetal-placental interface. 13,30,34,35 As more inflammatory cytokines are produced, tissue destruction can occur, affecting the structural integrity of the placenta. 13,30,32,35 These cytokines are related to the onset of labor, inducing a tenderness of the uterine muscles, stimulating uterine contractions and cervical dilation, and consequently, triggering preterm birth.…”

“…13,30,34,35 As more inflammatory cytokines are produced, tissue destruction can occur, affecting the structural integrity of the placenta. 13,30,32,35 These cytokines are related to the onset of labor, inducing a tenderness of the uterine muscles, stimulating uterine contractions and cervical dilation, and consequently, triggering preterm birth. 13,30,35 In some cases of preterm birth, elevated levels of these cytokines have been found in the amniotic fluid.…”

“…13,29 The destructive process of this disease involves both direct tissue damage resulting from the presence of bacterial products surrounding the tooth and its adjacent structures as well as indirect damage through the inflammatory response of the host in response to the bacteria. 13,15,17,30 According to research, the systemic inflammation due to periodontal infection and bacterial colonization in the oral cavity may have a role in the incidence of adverse pregnancy outcomes. 31 Researchers hypothesize that periodontal pathogens (inflammatory mediators) reach the maternal reproductive system through the bloodstream and cause an inflammatory cascade triggering a second round of inflammatory responses.…”