Proteomic signature of periodontal disease in pregnancy: Predictive validity for adverse outcomes

Abstract

The rate of preterm birth is a public health concern worldwide because it is increasing and efforts to prevent it have failed. We report a Clinically Relevant Complex Systematic Review (CSCSR) designed to identify and evaluate the best available evidence in support of the association between periodontal status in women and pregnancy outcome of preterm low birth weight. We hypothesize that the traditional limits of research synthesis must be expanded to incorporate a translational component. As a proof-of-concept model, we propose that this CSCSR can yield greater validity of efficacy and effectiveness through supplementing its recommendations with data of the proteomic signature of periodontal disease in pregnancy, which can contribute to addressing specifically the predictive validity for adverse outcomes. For this CRCSR, systematic reviews were identified through The National Library of MedicinePubmed, The Cochrane library, CINAHL, Google Scholar, Web of Science, and the American Dental Association web library. Independent reviewers quantified the relevance and quality of this literature with R-AMSTAR. Homogeneity and inter-rater reliability testing were supplemented with acceptable sampling analysis. Research synthesis outcomes were analyzed qualitatively toward a Bayesian inference, and converge to demonstrate a definite association between maternal periodontal disease and pregnancy outcome. This CRCSR limits heterogeneity in terms of periodontal disease, outcome measure, selection bias, uncontrolled confounders and effect modifiers. Taken together, the translational CRCSR model we propose suggests that further research is advocated to explore the fundamental mechanisms underlying this association, from a molecular and proteomic perspective.

Periodontal Disease and Pregnancy Outcomes: Overview of Systematic Reviews

“…We are aware of 1 previous overview of systematic reviews in this field, which was published in 2011 (Ramchandani et al 2011). Drawing evidence from 6 published systematic reviews on periodontal disease and preterm LBW only, Ramchandani et al concluded that “there is an association between maternal periodontal disease and adverse pregnancy outcomes” although they considered their conclusion “tentative” and highlighted the need for further studies in this field.…”

Methodological quality of meta-analyses of single-case experimental studies

“…The validity of R-AMSTAR has been investigated and supported in studies by Kung et al (2010) and Shea et al (2009). We decided to use the R-AMSTAR (like other researchers, such as Alarcón et al, 2017;Bao et al, 2014;Brossart et al, 2008;Corry et al, 2015;Deckert et al, 2014;Faggion & Giannakopoulos, 2013;Kowalczuk et al, 2015;O'Donnell et al, 2014;Parke et al, 2015;Pearce et al, 2015;Pinnock et al, 2017;Popovich et al, 2012;Ramchandani et al, 2010;Rotta et al, 2015;Schmitter, Sterzenbach, Faggion, & Krastl, 2013; Sygouros & Acar, 2013; Thompson, Schabrun, Romero, Bialocerkowski, & Marshall, 2016; Wei et al, 2015; Wells et al, 2013) because of its better and clearer guidance for quality assessment process and because of its higher transparency. Yet, as Pieper et al (2014) noted, there are still some issues with specific items.…”

Factores de riesgo asociados con enfermedad periodontal en mujeres en estado de embarazo

“…Estudios recientes han demostrado una asociación entre estas condiciones; sin embargo, no es claro si existe o no una relación causal entre ellos, ya que pueden influir varios factores maternos como son cuello uterino corto y la vaginosis bacteriana, que pueden interactuar sinérgicamente con la periodontitis e inducir partos prematuros [31,32].…”