Periodontitis as a Risk Factor for Preeclampsia

Silva, Genivaldo Moura da; Coutinho, Sônia Bechara; Piscoya, Maria Dilma B. V.; Ximenes, Ricardo A. A.; Jamelli, Silvia Regina

doi:10.1902/jop.2012.110256

Cited by 39 publications

(27 citation statements)

References 48 publications

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“…Only two studies [63], [64] gained the maximum score in the Selection outcome; nine studies [15], [19], [24], [25], [26], [52], [63], [64], [65] had the maximum score in the Comparability outcome; and all studies had a partial score in the Exposure outcome.…”

Section: Resultsmentioning

confidence: 94%

Relationship between Periodontitis and Pre-Eclampsia: A Meta-Analysis

et al. 2013

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BackgroundStudies have suggested controversial results regarding a possible association between pre-eclampsia (PE) and periodontal disease (PD) and no meta-analysis has been performed to clarify this issue.MethodsA literature search of electronic databases was performed for articles published through March 24, 2013, followed by a manual search of several dental and medical journals. The meta-analysis was conducted according to the recommendations of the Cochrane Collaboration and PRISMA. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed with the χ2-based Cochran Q test and I2 statistic. The level of significance was set at P <0.05.ResultsFifteen studies were included, including three cohort and 12 case-control studies. A positive association was found between PE and PD (OR 2.17, 95% CI 1.38–3.41, P = 0.0008). However, a high and significant heterogeneity was found (χ2 = 62.42, P<0.00001, I2 = 75%). In most cases, subgroup analysis had low power to detect significant differences between PE and non-PE groups.ConclusionBased on the findings of the meta-analysis, PD appears to be a possible risk factor for PE. However, given the important differences in the definitions and diagnoses of PD and PE among the studies, as well as their lack of good methodological quality, future trials are needed to confirm the results of the present meta-analysis.

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Section: Resultsmentioning

confidence: 94%

Relationship between Periodontitis and Pre-Eclampsia: A Meta-Analysis

et al. 2013

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“…Porphyromonas gingivalis (Pg) is an important Gram-negative periodontal pathogen of humans that is also implicated in promoting cardiovascular disease [19], low birth weight, IUGR, preeclampsia, and spontaneous preterm birth [15][16][17][20][21][22][23][24][25][26]. In women with complicated pregnancies, the rate of detection of Pg DNA or antigen within the uterine compartment ranges between 30 and 92% [15-17, 22, 25].…”

Section: Introductionmentioning

confidence: 99%

Porphyromonas gingivalis strain-dependent inhibition of uterine spiral artery remodeling in the pregnant rat†

Phillips

Brown

Progulske‐Fox

et al. 2018

Biology of Reproduction

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Porphyromonas gingivalis (Pg) is an important periodontal pathogen that is also implicated in pregnancy complications involving defective deep placentation (DDP). We hypothesized that Pg invasion of the placental bed promotes DDP. Pregnant rats were intravenously inoculated with sterile vehicle, Pg strain W83, or A7436 at gestation day (GD) 14 (acute cohort). Nonpregnant rats received repeated oral inoculations for 3 months before breeding (chronic cohort). Tissues and/or sera were collected at GD18 for analysis. Pg infection status was determined by seroconversion (chronic cohort) and by presence of Pg antigen in utero-placental tissues processed for histology and morphometric assessment of spiral artery remodeling. Mesometrial tissues from seropositive dams were analyzed for expression of interleukin 1β, 6, and 10, TNF, TGF-β, follistatin-related protein 3, and inhibin beta A chain since these genes regulate extravillous trophoblast invasion. The in situ distribution of W83 and A7436 antigen in utero-placental tissues was similar in both cohorts. In the acute cohort, mesometrial stromal necrosis was more common with W83, but arteritis was more common with A7436 infection (P < 0.05). Increased vascular necrosis was seen in mesometrium of chronically infected groups (P < 0.05). Only A7436-infected animals had increased fetal deaths, reduced spiral artery remodeling, reduced inhibin beta A expression, and an increased proportion of FSLT3 positive extravillous trophoblasts within spiral arteries. While infection with both Pg strains produced varying pathology of the deep placental bed, only infection with strain A7436 resulted in impaired spiral artery remodeling.Published by Oxford University Press on behalf of Society for the Study of Reproduction 2018. This work is written by (a) US Government employee(s) and is in the public domain in the US. 1045Downloaded from https://academic.oup.com/biolreprod/article-abstract/99/5/1045/4999895 by guest on 07 June 2019 1046 P. Phillips et al., 2018, Vol. 99, No. 5 Summary SentenceInvasion of the placental bed by Porphyromonas gingivalis impairs spiral artery remodeling and increases fetal loss in a microbial strain-dependent manner.

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“…Higher incidence of periodontal disease parameters were found in females with PH, suggesting that maternal periodontal disease during pregnancy is associated with an increased risk for the development of PH 12‐21 . However, several authors have failed to find support for the hypothesis of an association between periodontal parameters and PH in their studies 22‐27 …”

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confidence: 99%