Periodontal Infection as a Possible Risk Factor for Preterm Low Birth Weight

Abstract

Peridontal diseases are gram-negative anaerobic infections that can occur in women of childbearing age (18 to 34 years). In the present investigation we sought to determine whether the prevalence of maternal periodontal infection could be associated with preterm low birth weight (PLBW), controlling for known risk factors and potential covariates. A case-control study of 124 pregnant or postpartum mothers was performed. PLBW cases were defined as a mother with a birth of less than 2,500 g and one or more of the following: gestational age < 37 weeks, preterm labor (PTL), or premature rupture of membranes (PROM). Controls were normal birth weight infants (NBW). Assessments included a broad range of known obstetric risk factors, such as tobacco use, drug use, alcohol consumption, level of prenatal care, parity, genitourinary infections, and nutrition. Each subject received a periodontal examination to determine clinical attachment level. PLBW cases and primiparous PLBW cases (n = 93) had significantly worse periodontal disease than the respective NBW controls. Multivariate logistic regression models, controlling for other risk factors and covariates, demonstrated that periodontal disease is a statistically significant risk factor for PLBW with adjusted odds ratios of 7.9 and 7.5 for all PLBW cases and primiparous PLBW cases, respectively. These data indicate that periodontal diseases represent a previously unrecognized and clinically significant risk factor for preterm low birth weight as a consequence of either PTL or preterm PROM.

Fap2 of Fusobacterium nucleatum Is a Galactose-Inhibitable Adhesin Involved in Coaggregation, Cell Adhesion, and Preterm Birth

“…Periodontal disease is a risk factor for preterm labor (41)(42)(43)(44)(45), and F. nucleatum has been associated with preterm birth (46)(47)(48)(49)(50), stillbirth (51), and early-onset neonatal sepsis (52).…”

Maternal periodontitis induces intergenerational injuries on reproductive performance of adult female rat offspring

“…Studies with murine models and humans indicate that periodontal diseases may induce adverse pregnancy outcomes (OFFENBACHER et al, 1996;WANG et al, 2013). LPS from Porphyromonas gingivalis increased maternal blood pressure, induced placental and fetal growth restriction, and increased fetal resorptions in rats.…”

“…Substantial evidence suggests a direct link between periodontal disease in pregnant women and adverse pregnancy outcomes (PITIPHAT et al, 2008;MICHALOWICZ et al, 2011;PISCOYA et al, 2012;KUNNEN et al, 2014). Periodontal disease affects more than 40% of pregnant women (LIEFF et al, 2004) and has been linked to adverse pregnancy outcomes, such as preterm delivery (OFFENBACHER et al, 1996;MANNEM;CHAVA, 2011;BOBETSIS et al, 2006;TUCKER, 2006), smaller fetuses (COLLINS et al, 1994;KOTHIWALE et al, 2014), pre-ecclampsia (PATTANASHETTI et al, 2013MISRATH BANU;RAMAMURTHY, 2014), fetal loss (XIAO et al, 2013), and late miscarriage (MOORE et al, 2005) in the parental generation. However, all of these reproductive impairments have only been studied in the parental generation and not in subsequent generations.…”

Cuban maternity homes: a model to address at-risk pregnancy

“…This is important, since maternal oral infections have shown to be a reliable predictor of low birthweight. [8] Because getting Cubans into a dental chair can be like pulling teeth, maternity home dentists not only treat infections, but also fi ll cavities, do routine cleanings, and provide other necessary dental services for the duration of the woman's stay.…”