Study on association of maternal periodontitis and preeclampsia

Abstract

Background:The second most leading cause for maternal mortality is hypertensive disorder of pregnancy, which accounts for 15% of total deaths and still births. Preeclampsia is a complex disorder affecting about 5-10% of the obstetric population, resulting from deficient placental implantation during the first half of pregnancy and hypertensive disorders after 20 th week of gestation in a previously normotensive woman. Periodontal diseases are plaque induced infections and pathological changes of the periodontium, divided into two categories: gingivitis and periodontitis. Preeclampsia and periodontitis have been found to be associated with high circulating levels of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-10, and IL-6 resulting in inflammatory vascular damage leading to placental endothelial alterations. Periodontal microbiota plays a significant role in systemic diseases directly through a pro-inflammatory effect or indirectly through the host-mediated destruction. The similarities in their pathophysiologies have led to the hypothesis of periodontal disease being a risk factor for preeclampsia. Aim of the study: 1. The aim of the present study was to evaluate the association between maternal periodontitis and preeclampsia. 2. Also the association of periodontitis and preeclampsia after matching for primi Parity. Materials and Methods: The present study was conducted at Institute of at Madras Medical College, Chennai Tamilnadu during the academic year 2017. The study was done in 200 patients for duration of 8 months. Participants were informed about the aims of the study and a written informed consent was obtained from them. An eligible sample was selected based on the following criteria. Results: Of the 200 patients analysed 92 were found to have periodontitis, which accounts for 46% of study population. Out of the 92 patients having periodontitis 67 patients were preeclamptic. The study showed no significant association between age, parity, socioeconomic status and place of residence to periodontitis. There is significant association between maternal periodontitis and preeclampsia. Conclusion: Delaying treatment may result in more complex problems. Counseling should include reinforcement of routine oral health maintenance, such as limiting sugary foods and drinks, brushing twice a day with fluoridated toothpaste, flossing once daily, and dental visits twice a year. Dental providers often recommend the use of chlorhexidine and fluoridated mouth rinses, and xylitol-containing chewing gum to decrease oral bacteria. No adverse effects have been reported with these products during pregnancy.