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Winckler K, Bukkehave KH, Tarnow L, Iversen PB, Damgaard C, Ditlev SB, Kofoed-Enevoldsen A, Fischer HM, Dueholm SCH, Lauenborg J, Trier C, Heitmann BL. The prevention of adverse pregnancy outcomes by periodontal treatment during pregnancy (PROBE) intervention study-A controlled intervention study: Protocol paper. PLoS One 2024; 19:e0302010. [PMID: 38739615 PMCID: PMC11090325 DOI: 10.1371/journal.pone.0302010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/21/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION Pregnancy increases the risk of periodontitis due to the increase in progesterone and estrogen. Moreover, periodontitis during pregnancy is associated with development of pregnancy and birth related complications. The aim of this study is to determine, whether periodontal treatment during pregnancy can reduce systemic inflammation and lower the risk of adverse pregnancy and birth related outcomes. METHODS AND ANALYSIS The PROBE study is a non-randomized controlled intervention study conducted among 600 pregnant women with periodontitis. The women will be recruited among all pregnant women at two Danish hospitals in Region Zealand during their nuchal translucency scan and will subsequently be screened for periodontitis. The intervention group includes 300 pregnant women, who will be offered state-of-the-art periodontal treatment during pregnancy. The control group includes additional 300 pregnant women, who will be offered periodontal treatment after giving birth. Outcome measures include periodontal measures, inflammatory, hormonal and glycaemic markers as well as the prevalence of preterm birth risk, low birth weight and risk markers of gestational diabetes mellitus (GDM) and preeclampsia that will be collected from all screened women and further during pregnancy week 20 and pregnancy week 35 for women enrolled in the intervention. ETHICS AND DISSEMINATION The study's findings will be published in peer reviewed journals and disseminated at national and international conferences and through social media. The PROBE study is designed to provide important new knowledge as to whether periodontal treatment during pregnancy can reduce the prevalence of complications related to pregnancy and birth. CLINICAL TRIALS REGISTRATION The study was registered on clinicaltrials.gov (NCT06110143).
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Affiliation(s)
- Karoline Winckler
- The Research Unit for Dietary Studies, The Parker Institute, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kathrine Hansen Bukkehave
- The Research Unit for Dietary Studies, The Parker Institute, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lise Tarnow
- Steno Diabetes Center Sjælland, Herlev, Denmark
| | | | - Christian Damgaard
- Department of Odontology, Section for Oral Biology and Immunopathology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sisse Bolm Ditlev
- Copenhagen Center for Translational Research, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark
| | | | | | | | - Jeannet Lauenborg
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Cæcilie Trier
- Department of Obstetrics and Gynecology, Nykoebing Falster Hospital, Nykøbing Falster, Denmark
| | - Berit Lilienthal Heitmann
- The Research Unit for Dietary Studies, The Parker Institute, Copenhagen University Hospital, Copenhagen, Denmark
- The Boden Group, Charles Perkins Centre, University of Sydney, Camperdown, Australia
- Department of Public Health, Section for General Practice, University of Copenhagen, Copenhagen, Denmark
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Abouzaid M, Howidi N, Badran Z, Mohammed G, Mousa NA. The potential role of the gingival crevicular fluid biomarkers in the prediction of pregnancy complications. Front Med (Lausanne) 2023; 10:1168625. [PMID: 37342498 PMCID: PMC10277493 DOI: 10.3389/fmed.2023.1168625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/18/2023] [Indexed: 06/23/2023] Open
Abstract
Early and minimally invasive methods are required to predict the risk of multiple adverse pregnancy outcomes. A potential technique with growing interest utilizes the gingival crevicular fluid (GCF), a physiological serum exudate found in the healthy gingival sulcus and in the periodontal pocket in inflammatory conditions. Analysis of biomarkers in the GCF is a minimally invasive method that can be feasible and cost-effective. The potential use of GCF biomarkers along with other clinical indicators in early pregnancy may provide reliable predictors of several adverse pregnancy outcomes, therefore, reducing both maternal and fetal morbidities. Various studies have reported that increased or decreased concentrations of different biomarkers in GCF are associated with a high risk of developing pregnancy complications. In particular, such associations have been commonly demonstrated with gestational diabetes, pre-eclampsia, and pre-term birth. However, limited evidence is available regarding other pregnancy complications such as preterm premature rupture of membranes, recurrent miscarriage, small for gestational age, and hyperemesis gravidarum. In this review, we discuss the reported association between individual GCF biomarkers and common pregnancy complications. Future research is required to provide more solid evidence of the predictive value of those biomarkers in estimating women's risk for each disorder.
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Affiliation(s)
- Maryam Abouzaid
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Nourhan Howidi
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Zahi Badran
- Periodontology Unit, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Ghada Mohammed
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Noha A. Mousa
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Gare J, Kanoute A, Meda N, Viennot S, Bourgeois D, Carrouel F. Periodontal Conditions and Pathogens Associated with Pre-Eclampsia: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137194. [PMID: 34281133 PMCID: PMC8297070 DOI: 10.3390/ijerph18137194] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/01/2021] [Accepted: 07/03/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pre-eclampsia, the second most frequent direct source of maternal mortality, is a multisystem gestational disorder characterized by proteinuria and maternal hypertension after the 20th gestational week. Although the causes of pre-eclampsia are still discussed, research has suggested that the placenta has a central place in the pathogenesis of this disease. Moreover, current surveys indicated that periodontal disorders observed during the pregnancy and more particularly, periodontal pathogens could be link to the risk of pre-eclampsia. OBJECTIVES This article aims to review recent studies focusing on periodontal conditions and pathogens associated with pre-eclampsia. METHODS The process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. RESULTS Metabolic conditions, immunological changes, fluctuating progesterone and estrogen levels of the pregnant woman induce a dysbiosis of the oral microbiota and contribute to increase inflammation of periodontal tissues. Periodontal pathogens could diffuse through the bloodstream inducing a placenta inflammatory response as well as inflammatory molecules produced in response to periodontopathogens could migrate through the bloodstream leading to a placenta inflammatory response. Also, periodontopathogens can colonize the vaginal microbiota through the gastrointestinal tract or during oro-genital contacts. CONCLUSION A cumulative bi-directional relationship between periodontal conditions, pathogens and the pre-eclampsia exists.
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Affiliation(s)
- Jocelyne Gare
- Laboratory P2S (Health Systemic Process), UR4129, University Claude Bernard of Lyon 1, University of Lyon, Lyon, France; (J.G.); (S.V.); (D.B.)
- Public Health Laboratory (LASAP), ED2S Doctoral School of Sciences and Health, University Joseph Ki Zerbo, Ouagadougou 7021, Burkina Faso;
| | - Aida Kanoute
- Public Health Service, Department of Dentistry, Faculty of Medicine, Pharmacy and Dentistry, University Cheikh Anta Diop, Dakar 10700, Senegal;
| | - Nicolas Meda
- Public Health Laboratory (LASAP), ED2S Doctoral School of Sciences and Health, University Joseph Ki Zerbo, Ouagadougou 7021, Burkina Faso;
| | - Stephane Viennot
- Laboratory P2S (Health Systemic Process), UR4129, University Claude Bernard of Lyon 1, University of Lyon, Lyon, France; (J.G.); (S.V.); (D.B.)
| | - Denis Bourgeois
- Laboratory P2S (Health Systemic Process), UR4129, University Claude Bernard of Lyon 1, University of Lyon, Lyon, France; (J.G.); (S.V.); (D.B.)
| | - Florence Carrouel
- Laboratory P2S (Health Systemic Process), UR4129, University Claude Bernard of Lyon 1, University of Lyon, Lyon, France; (J.G.); (S.V.); (D.B.)
- Correspondence: ; Tel.: +33-4-78-78-57-44
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Caneiro-Queija L, López-Carral J, Martin-Lancharro P, Limeres-Posse J, Diz-Dios P, Blanco-Carrion J. Non-Surgical Treatment of Periodontal Disease in a Pregnant Caucasian Women Population: Adverse Pregnancy Outcomes of a Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3638. [PMID: 31569780 PMCID: PMC6801449 DOI: 10.3390/ijerph16193638] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/22/2019] [Accepted: 09/24/2019] [Indexed: 02/04/2023]
Abstract
AIM To analyze if non-surgical treatment of periodontitis in a pregnant Caucasian women population can reduce adverse pregnancy outcomes. METHODS AND RESULTS A parallel randomized clinical trial was designed and approved by the Ethical Committee of Sanitary Area Santiago-Lugo, Spain (registration number: 2016/451). Forty patients with periodontitis stage II grade B were randomly allocated to receive either comprehensive non-surgical periodontal therapy (test group; n = 20) or professional tooth cleaning (control group; n = 20) before 24 gestational weeks. Randomization was computer-generated by the statistic program Epidat v.4.1 and allocation was performed using sealed opaque envelopes. Clinical measurements and peripheral blood samples for biochemical variables were collected at baseline, in the middle of second trimester before non-surgical treatment, and in the third trimester. Microbiological samples were collected in the second and third trimester. A statistically significant reduction was verified in all clinical and microbiological parameters after periodontal treatment in the test group. No significant differences were observed for the rest of the variables, including preterm birth and/or low birth weight. No adverse events related to periodontal treatment were reported. CONCLUSIONS Non-surgical periodontal treatment in Caucasian patients with periodontitis stage II grade B did not significantly reduce the risk of adverse pregnancy outcomes.
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Affiliation(s)
- Leticia Caneiro-Queija
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
| | - Jose López-Carral
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
- Department of Obstetrics and Gynecology, Clinic University Hospital of Santiago de Compostela, 15782 Santiago de Compostela, Spain.
| | - Pablo Martin-Lancharro
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
- Department of Obstetrics and Gynecology, Clinic University Hospital of Santiago de Compostela, 15782 Santiago de Compostela, Spain.
| | - Jacobo Limeres-Posse
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
- Special Needs Unit, School of Medicine and Dentistry, Santiago de Compostela University, 15782 Santiago de Compostela, Spain.
| | - Pedro Diz-Dios
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
- Special Needs Unit, School of Medicine and Dentistry, Santiago de Compostela University, 15782 Santiago de Compostela, Spain.
| | - Juan Blanco-Carrion
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
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Calcium and vitamin D supplementation and/or periodontal therapy in the treatment of periodontitis among Brazilian pregnant women: protocol of a feasibility randomised controlled trial (the IMPROVE trial). Pilot Feasibility Stud 2019; 5:38. [PMID: 30873290 PMCID: PMC6402123 DOI: 10.1186/s40814-019-0417-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 02/13/2019] [Indexed: 12/16/2022] Open
Abstract
Background Periodontitis is a common oral inflammation, which is a risk factor for adverse pregnancy outcomes. Intakes of vitamin D and calcium are inversely associated with occurrence and progression of periodontitis. This study aims to assess the feasibility of a multi-component intervention, including provision of milk powder supplemented with calcium and vitamin D and periodontal therapy (PT), for improving maternal periodontal health and metabolic and inflammatory profiles of low-income Brazilian pregnant women with periodontitis. Methods The IMPROVE trial is a feasibility randomised controlled trial (RCT) with a 2 × 2 factorial design with a parallel process evaluation. Pregnant women with periodontitis, aged 18–40 years and with < 20 gestational weeks (n = 120) were recruited and randomly allocated into four groups: (1) fortified sachet (vitamin D and calcium) and powdered milk plus PT during pregnancy, (2) placebo sachet and powdered milk plus PT during pregnancy, (3) fortified sachet (vitamin D and calcium) and powdered milk plus PT after delivery and (4) placebo sachet and powdered milk plus PT after delivery. Dentists and participants are blinded to fortification. Acceptability of study design, recruitment strategy, random allocation, data collection procedures, recruitment rate, adherence and attrition rate will be evaluated. Data on serum levels of vitamin D, calcium and inflammatory biomarkers; clinical periodontal measurements; anthropometric measurements; and socio-demographic questionnaires are collected at baseline, third trimester and 6–8 weeks postpartum. Qualitative data are collected using focus group, for analysis of favourable factors and barriers related to study adherence. Discussion Oral health and mineral/vitamin supplementation are much overlooked in the public prenatal assistance in Brazil and of scarcity of clinical trials addressing these issues in low and middle-income countries,. To fill this gap the present study was designed to assess the feasibility of a RCT on acceptability of a multi-component intervention combining conventional periodontal treatment and consumption of milk fortified with calcium-vitamin D for improving periodontal conditions and maternal metabolic and inflammation status, among Brazilian low-income pregnant women with periodontitis. Thus, we hope that this relatively low-cost and safe multicomponent intervention can help reduce inflammation, improve maternal periodontal health and metabolic profile and consequently prevent negative gestational outcomes. Trial registration NCT, NCT03148483. Registered on May 11, 2017.
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Manrique-Corredor EJ, Orozco-Beltran D, Lopez-Pineda A, Quesada JA, Gil-Guillen VF, Carratala-Munuera C. Maternal periodontitis and preterm birth: Systematic review and meta-analysis. Community Dent Oral Epidemiol 2019; 47:243-251. [PMID: 30812054 DOI: 10.1111/cdoe.12450] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 01/21/2019] [Accepted: 02/09/2019] [Indexed: 11/28/2022]
Abstract
AIM To assess the association between periodontitis and preterm birth in women of childbearing age. MATERIALS AND METHODS This review included analytical case-control studies and prospective cohort studies evaluating the association between maternal periodontitis and preterm birth. Of the 3104 screened articles, 31 met the inclusion criteria for the review, and 20 met the quality criteria. The selected studies included a total of 10 215 women. RESULTS Twenty articles contributed to the meta-analysis; 16 used a case-control design, and 4 were prospective cohort studies. The study heterogeneity was low (Q = 24.2464; P = 0.1869; I2 = 21.63%). A positive association between maternal periodontitis and preterm birth was found in 60% of the studies. Under the random-effects model, meta-analysis gave an odds ratio (OR) of 2.01 (95% CI 1.71, 2.36), representing a significant positive association between the explanatory and outcome variables. CONCLUSION Pregnant mothers with periodontitis double the risk of preterm birth. There is a lack of international consensus for diagnosing maternal periodontitis.
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Affiliation(s)
- Edwar J Manrique-Corredor
- Escuela de Medicina, Universidad Pedagógica y Tecnológica de Colombia, Tunja, Boyacá, Colombia.,Chair of Family Medicine, Miguel Hernandez University, San Juan de Alicante, Spain
| | | | - Adriana Lopez-Pineda
- Chair of Family Medicine, Miguel Hernandez University, San Juan de Alicante, Spain
| | - Jose A Quesada
- Chair of Family Medicine, Miguel Hernandez University, San Juan de Alicante, Spain
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Haney KL, Beavers KS. Prevention of Dental Disease. Pediatr Dent 2019. [DOI: 10.1016/b978-0-323-60826-8.00015-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Vivares-Builes AM, Rangel-Rincón LJ, Botero JE, Agudelo-Suárez AA. Gaps in Knowledge About the Association Between Maternal Periodontitis and Adverse Obstetric Outcomes: An Umbrella Review. J Evid Based Dent Pract 2018; 18:1-27. [DOI: 10.1016/j.jebdp.2017.07.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/04/2017] [Accepted: 07/10/2017] [Indexed: 01/01/2023]
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Perinatal Mortality Associated with Positive Postmortem Cultures for Common Oral Flora. Infect Dis Obstet Gynecol 2017; 2017:9027918. [PMID: 28325959 PMCID: PMC5343271 DOI: 10.1155/2017/9027918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/07/2017] [Indexed: 11/25/2022] Open
Abstract
Introduction. To investigate whether maternal oral flora might be involved in intrauterine infection and subsequent stillbirth or neonatal death and could therefore be detected in fetal and neonatal postmortem bacterial cultures. Methods. This retrospective study of postmortem examinations from 1/1/2000 to 12/31/2010 was searched for bacterial cultures positive for common oral flora from heart blood or lung tissue. Maternal age, gestational age, age at neonatal death, and placental and fetal/neonatal histopathological findings were collected. Results. During the study period 1197 postmortem examinations (861 stillbirths and 336 neonatal deaths) were performed in our hospital with gestational ages ranging from 13 to 40+ weeks. Cultures positive for oral flora were identified in 24 autopsies including 20 pure and 8 mixed growths (26/227, 11.5%), found in 16 stillbirths and 8 neonates. Microscopic examinations of these 16 stillbirths revealed 8 with features of infection and inflammation in fetus and placenta. The 7 neonatal deaths within 72 hours after birth grew 6 pure isolates and 1 mixed, and 6 correlated with fetal and placental inflammation. Conclusions. Pure isolates of oral flora with histological evidence of inflammation/infection in the placenta and fetus or infant suggest a strong association between maternal periodontal conditions and perinatal death.
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Nagaoka K, Yanagihara K, Harada Y, Yamada K, Migiyama Y, Morinaga Y, Izumikawa K, Kohno S. Quantitative detection of periodontopathic bacteria in lower respiratory tract specimens by real-time PCR. J Infect Chemother 2017; 23:69-73. [DOI: 10.1016/j.jiac.2016.09.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 08/31/2016] [Accepted: 09/28/2016] [Indexed: 11/27/2022]
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Nagaoka K, Yanagihara K, Morinaga Y, Kohno S. Detection of Fusobacterium nucleatum in two cases of empyema and lung abscess using paromomycin-vancomycin supplemented Brucella HK agar. Anaerobe 2016; 43:99-101. [PMID: 28034636 DOI: 10.1016/j.anaerobe.2016.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/21/2016] [Accepted: 12/22/2016] [Indexed: 01/01/2023]
Abstract
Fusobacterium nucleatum was found in patients with empyema or pulmonary abscess, using paromomycin-vancomycin Brucella HK agar. In vitro examination revealed that growth of the strains differed significantly in different media. Clinicians should be aware that suboptimal F. nucleatum cultivation methods may result in an underestimation of its frequency.
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Affiliation(s)
- Kentaro Nagaoka
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; First Department of Internal Medicine, Hokkaido University Hospital, Hokkaido, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Yoshitomo Morinaga
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shigeru Kohno
- Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Global COE Program, Nagasaki University, Nagasaki, Japan
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Chiga S, Ohba T, Tanoue D, Kawase H, Katoh T, Katabuchi H. Validity of Self-Reported Periodontal Disease Questionnaire among Pregnant Women. Nihon Eiseigaku Zasshi 2016; 71:260-266. [PMID: 27725429 DOI: 10.1265/jjh.71.260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES As part of the Kumamoto RAINBOW Project, a multifaceted implementation of the prevention of premature labor, we investigated pregnant women's oral health status and assessed the validity of a self-reported periodontal disease questionnaire. METHODS We examined the oral health status of pregnant women and asked them for subjective descriptions of symptoms of periodontitis both in the first and the second half of their pregnancy in Kumamoto Prefecture from August 2012 to January 2014. The Community Periodontal Index (CPI) was used to assess the periodontal condition, and women having periodontal pockets with depths of ≥4 mm were catecogorized as having periodontitis. The results were the scores of the self-questionnaire for periodontal disease prepared by the Japan Dental Association. RESULTS Of the 9,527 pregnant women who received periodontal check- ups during the first half of pregnancy, 32 percent were diagnosed as having periodontitis. The self-questionnaire had a sensitivity of 51.2% and a specificity of 62.9% for pregnant women to predict their periodontal disease. Then, we evaluated the importance of each question by logistic regression analysis and extracted the useful items. An increased sensitivity (79.9%) was obtained with the best of the modified questionnaire. CONCLUSIONS To our knowledge, this is the first report of the evaluation of the usefulness of the self-reported periodontal disease questionnaire for pregnant women. The current self-questonnaire used for the general adult population was less sensitive for pregnant women. Our modified questionnaire showed an improved sensitivity for diagnosing periodontitis, but its specificity remained low. A specialized self-questionnaire for periodontal disease in pregnant women should be designed.
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Affiliation(s)
- Sakura Chiga
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University
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Linden GJ, Lyons A, Scannapieco FA. Periodontal systemic associations: review of the evidence. J Clin Periodontol 2016; 40 Suppl 14:S8-19. [PMID: 23627336 DOI: 10.1111/jcpe.12064] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2012] [Indexed: 12/24/2022]
Abstract
AIM To critically appraise recent research into associations between periodontal disease and systemic diseases and conditions specifically respiratory disease, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome and cancer. METHODS A MEDLINE literature search of papers published between 2002 and April 2012 was conducted. Studies that included periodontitis as an exposure were identified. Cross-sectional epidemiological investigations on large samples, prospective studies and systematic reviews formed the basis of the narrative review. A threshold set for the identification of periodontitis was used to identify those studies that contributed to the conclusions of the review. RESULTS Many of the investigations were cross-sectional secondary analyses of existing data sets in particular the NHANES studies. There were a small number of systematic reviews and prospective studies. There was substantial variability in the definitions of exposure to periodontitis. A small number of studies met the threshold set for periodontitis and supported associations; however, in some of the chronic diseases there were no such studies. There was strong evidence from randomized controlled trials that interventions, which improve oral hygiene have positive effects on the prevention of nosocomial pneumonias. CONCLUSIONS There was substantial heterogeneity in the definitions used to identify periodontitis and very few studies met a stringent threshold for periodontitis. Published evidence supports modest associations between periodontitis and some, although not all, of the diseases and conditions reviewed. There is a need to reach a consensus on what constitutes periodontitis for future studies of putative associations with systemic diseases.
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Affiliation(s)
- Gerard J Linden
- Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK.
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Linden GJ, Lyons A, Scannapieco FA. Periodontal systemic associations: review of the evidence. J Periodontol 2016; 84:S8-S19. [PMID: 23631586 DOI: 10.1902/jop.2013.1340010] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIM To critically appraise recent research into associations between periodontal disease and systemic diseases and conditions specifically respiratory disease, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome and cancer. METHODS A MEDLINE literature search of papers published between 2002 and April 2012 was conducted. Studies that included periodontitis as an exposure were identified. Cross-sectional epidemiological investigations on large samples, prospective studies and systematic reviews formed the basis of the narrative review. A threshold set for the identification of periodontitis was used to identify those studies that contributed to the conclusions of the review. RESULTS Many of the investigations were cross-sectional secondary analyses of existing data sets in particular the NHANES studies. There were a small number of systematic reviews and prospective studies. There was substantial variability in the definitions of exposure to periodontitis. A small number of studies met the threshold set for periodontitis and supported associations; however, in some of the chronic diseases there were no such studies. There was strong evidence from randomized controlled trials that interventions, which improve oral hygiene have positive effects on the prevention of nosocomial pneumonias. CONCLUSIONS There was substantial heterogeneity in the definitions used to identify periodontitis and very few studies met a stringent threshold for periodontitis. Published evidence supports modest associations between periodontitis and some, although not all, of the diseases and conditions reviewed. There is a need to reach a consensus on what constitutes periodontitis for future studies of putative associations with systemic diseases.
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Affiliation(s)
- Gerard J Linden
- Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK.
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González-Fernández D, Koski KG, Sinisterra OT, Del Carmen Pons E, Murillo E, Scott ME. Interactions among urogenital, intestinal, skin, and oral infections in pregnant and lactating Panamanian Ngäbe women: a neglected public health challenge. Am J Trop Med Hyg 2015; 92:1100-10. [PMID: 25825387 PMCID: PMC4458810 DOI: 10.4269/ajtmh.14-0547] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 02/21/2015] [Indexed: 01/09/2023] Open
Abstract
Interrelationships among bacteria, protozoa, helminths, and ectoparasites were explored in a cross-sectional survey of 213 pregnant and 99 lactating indigenous women. Prevalences in pregnancy and lactation, respectively, were: vaginitis (89.2%; 46.8%), vaginal trichomoniasis (75.3%; 91.1%), bacterial vaginosis (BV; 60.6%; 63.3%), hookworm (56.6%; 47.8%), asymptomatic bacteriuria/urinary tract infection (AB/UTI; 56.2%; 36.2%), cervicitis (33.3%; 6.3%), vaginal yeast (24.9%; 11.4%), Ascaris (32.5%; 17.4%), vaginal diplococci (20.4%; 31.6%), caries (19.7%; 18.2%), scabies (17.4%; 8.1%), and Trichuris (12.5%; 8.7%). Multiple regressions revealed positive associations during pregnancy (trichomoniasis and AB/UTI; diplococci and Ascaris) and lactation (yeast and scabies). Negative associations were detected in pregnancy (BV and trichomoniasis; hookworm and diplococci) and lactation (BV and yeast). Vaginal Lactobacillus reduced odds of diplococci in pregnancy and lactation, but increased Ascaris eggs per gram (epg) and odds of trichomoniasis in pregnancy and yeast in lactation. These associations raised a concern that treatment of one condition may increase the risk of another.
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Affiliation(s)
- Doris González-Fernández
- Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, McGill University, Ste-Anne de Bellevue, Quebec, Canada; Department of Biochemistry, University of Panamá, Panamá City, Panamá; Department of Nutritional Health, Ministry of Health, Panamá City, Panamá
| | - Kristine G Koski
- Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, McGill University, Ste-Anne de Bellevue, Quebec, Canada; Department of Biochemistry, University of Panamá, Panamá City, Panamá; Department of Nutritional Health, Ministry of Health, Panamá City, Panamá
| | - Odalis Teresa Sinisterra
- Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, McGill University, Ste-Anne de Bellevue, Quebec, Canada; Department of Biochemistry, University of Panamá, Panamá City, Panamá; Department of Nutritional Health, Ministry of Health, Panamá City, Panamá
| | - Emérita Del Carmen Pons
- Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, McGill University, Ste-Anne de Bellevue, Quebec, Canada; Department of Biochemistry, University of Panamá, Panamá City, Panamá; Department of Nutritional Health, Ministry of Health, Panamá City, Panamá
| | - Enrique Murillo
- Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, McGill University, Ste-Anne de Bellevue, Quebec, Canada; Department of Biochemistry, University of Panamá, Panamá City, Panamá; Department of Nutritional Health, Ministry of Health, Panamá City, Panamá
| | - Marilyn E Scott
- Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, McGill University, Ste-Anne de Bellevue, Quebec, Canada; Department of Biochemistry, University of Panamá, Panamá City, Panamá; Department of Nutritional Health, Ministry of Health, Panamá City, Panamá
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Chiga S, Ohba T, Miyoshi J, Tanoue D, Kawase H, Katoh T, Katabuchi H. [Oral health status of pregnant women in Kumamoto Prefecture]. Nihon Eiseigaku Zasshi 2015; 70:167-72. [PMID: 25994349 DOI: 10.1265/jjh.70.167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES As part of Kumamoto RAINBOW Project, which is a multifaceted implementation for the prevention of premature labor, we investigated pregnant women's oral health status and assessed the effects of dental care and oral hygiene instruction. METHODS We examined the oral health status of pregnant women both in the first and the second half of pregnancy in Kumamoto Prefecture from 2012 to 2014. The Community Periodontal Index (CPI) was used to assess the periodontal condition, and women having periodontal pockets with a depth ≥4 mm were defined as suffering from periodontitis. This project covered the cost of dental checkups. RESULTS Of the 20,702 pregnant women enrolled in this project, 9,527 (46.0%) received dental checkups during the first half of pregnancy. The response rate of dental examinations in Kumamoto City (63.3%), the capital city of Kumamoto Prefecture, was significantly higher than that of the other local areas (32.0%). In Kumamoto City, 4,890 women (83.4%) had dental examinations at the city office when they received a maternal handbook. Three thousand forty-five women (32.0%) had periodontitis. Among 1,605 women who received oral examinations twice at dental clinics, 698 received nonsurgical interventions. Dental interventions significantly decreased the prevalence of periodontitis in pregnant women (55.1% to 45.1%). Dental examinations without interventions also significantly decreased the prevalence of periodontitis (44.6% to 39.9%). CONCLUSIONS Pregnant women living in Kumamoto City had higher rate of visits to dental clinics for checkups than those in other areas. Periodontitis was found in one-third of pregnant women. Not only dental interventions, but also dental examinations improve pregnant women's oral health status.
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Affiliation(s)
- Sakura Chiga
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University
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Raiten DJ, Sakr Ashour FA, Ross AC, Meydani SN, Dawson HD, Stephensen CB, Brabin BJ, Suchdev PS, van Ommen B. Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE). J Nutr 2015; 145:1039S-1108S. [PMID: 25833893 PMCID: PMC4448820 DOI: 10.3945/jn.114.194571] [Citation(s) in RCA: 150] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 06/08/2014] [Accepted: 10/29/2014] [Indexed: 02/06/2023] Open
Abstract
An increasing recognition has emerged of the complexities of the global health agenda—specifically, the collision of infections and noncommunicable diseases and the dual burden of over- and undernutrition. Of particular practical concern are both 1) the need for a better understanding of the bidirectional relations between nutritional status and the development and function of the immune and inflammatory response and 2) the specific impact of the inflammatory response on the selection, use, and interpretation of nutrient biomarkers. The goal of the Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE) is to provide guidance for those users represented by the global food and nutrition enterprise. These include researchers (bench and clinical), clinicians providing care/treatment, those developing and evaluating programs/interventions at scale, and those responsible for generating evidence-based policy. The INSPIRE process included convening 5 thematic working groups (WGs) charged with developing summary reports around the following issues: 1) basic overview of the interactions between nutrition, immune function, and the inflammatory response; 2) examination of the evidence regarding the impact of nutrition on immune function and inflammation; 3) evaluation of the impact of inflammation and clinical conditions (acute and chronic) on nutrition; 4) examination of existing and potential new approaches to account for the impact of inflammation on biomarker interpretation and use; and 5) the presentation of new approaches to the study of these relations. Each WG was tasked with synthesizing a summary of the evidence for each of these topics and delineating the remaining gaps in our knowledge. This review consists of a summary of the INSPIRE workshop and the WG deliberations.
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Affiliation(s)
- Daniel J Raiten
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD;
| | - Fayrouz A Sakr Ashour
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD
| | - A Catharine Ross
- Departments of Nutritional Sciences and Veterinary and Biomedical Science and Center for Molecular Immunology and Infectious Disease, Pennsylvania State University, University Park, PA
| | - Simin N Meydani
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Harry D Dawson
- USDA-Agricultural Research Service, Beltsville Human Nutrition Research Center, Diet, Genomics, and Immunology Laboratory, Beltsville, MD
| | - Charles B Stephensen
- Agricultural Research Service, Western Human Nutrition Research Center, USDA, Davis, CA
| | - Bernard J Brabin
- Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Global Child Health Group, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Parminder S Suchdev
- Department of Pediatrics and Global Health, Emory University, Atlanta, GA; and
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López NJ, Uribe S, Martinez B. Effect of periodontal treatment on preterm birth rate: a systematic review of meta-analyses. Periodontol 2000 2014; 67:87-130. [DOI: 10.1111/prd.12073] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2014] [Indexed: 01/08/2023]
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Huang X, Wang J, Liu J, Hua L, Zhang D, Hu T, Ge ZL. Maternal periodontal disease and risk of preeclampsia: A meta-analysis. ACTA ACUST UNITED AC 2014; 34:729-735. [DOI: 10.1007/s11596-014-1343-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 06/26/2014] [Indexed: 12/26/2022]
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Sgolastra F, Petrucci A, Severino M, Gatto R, Monaco A. Relationship between periodontitis and pre-eclampsia: a meta-analysis. PLoS One 2013; 8:e71387. [PMID: 23990948 PMCID: PMC3747173 DOI: 10.1371/journal.pone.0071387] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 07/01/2013] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Studies 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. METHODS A 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 χ(2)-based Cochran Q test and I(2) statistic. The level of significance was set at P <0.05. RESULTS Fifteen 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 (χ(2) = 62.42, P<0.00001, I(2) = 75%). In most cases, subgroup analysis had low power to detect significant differences between PE and non-PE groups. CONCLUSION Based 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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Affiliation(s)
- Fabrizio Sgolastra
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ambra Petrucci
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Marco Severino
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Roberto Gatto
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Annalisa Monaco
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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Schenkein HA, Bradley JL, Purkall DB. Anticardiolipin in porphyromonas gingivalis antisera causes fetal loss in mice. J Dent Res 2013; 92:814-8. [PMID: 23857644 DOI: 10.1177/0022034513497959] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
β2-glycoprotein I (β2GPI)-dependent anticardiolipin autoantibodies (aCl) are associated with thrombosis and fetal loss. Some microbial pathogens can induce pathogenic antibodies cross-reactive with β2GPI. Sera from a significant percentage of periodontitis patients contain aCl, and some periodontal pathogens contain antigens with peptide sequences having homology to β2GPI. We hypothesized that antibodies raised against P. gingivalis (aPg) contain pathogenic aCl that induce fetal resorption. We immunized mice with β2GPI, P. gingivalis W83, or an arg-gingipain-defective mutant of P. gingivalis (HF18). IgG fractions of aPg were immunoabsorbed to remove aCl-like antibodies (abs-aPg). IgG fractions were administered intravenously into tail veins of mated BALB/c females at day 0 of pregnancy. At day 15, the proportions of fetal resorptions were evaluated. The prevalence of fetal loss was significantly greater in the aPg group than in the control IgG group (21.2% vs. 5.3%, p = .001), and greater in the aPg group than in the abs-aPg group (21.2% vs. 12%, p < .05). There were no fetal resorptions observed in the aPgHF18 group (p = .0005 compared with aPg, p = .17 compared with control). aPg antibody contains activity consistent with pathogenic aCl, and the antigen inducing the antibodies that cause increased fetal loss may be on the arg-gingipain protease of P. gingivalis.
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Affiliation(s)
- H A Schenkein
- Virginia Commonwealth University, School of Dentistry, Department of Periodontics, Richmond, VA, USA.
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23
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Pirie M, Linden G, Irwin C. Intrapregnancy non-surgical periodontal treatment and pregnancy outcome: a randomized controlled trial. J Periodontol 2012; 84:1391-400. [PMID: 23237583 DOI: 10.1902/jop.2012.120572] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The purpose of the present study is to investigate the potential link between maternal periodontitis and pregnancy outcomes, including preterm birth (<37 weeks) and low birth weight (<2,500 g). METHODS Ninety nine pregnant females with mild/moderate periodontitis were randomly allocated to a control (n = 50) or test (n = 49) group. Test group participants received intrapregnancy non-surgical periodontal treatment, whereas this was deferred until after delivery for controls. Demographic and baseline clinical data were obtained for all participants at initial assessment pretreatment. Clinical data were rerecorded for test participants at review 8 weeks after treatment. Birth outcomes were completed at delivery by midwives who also collected cord blood samples when possible; the latter were analyzed to determine the presence/levels of cytokines interleukin (IL)-1β, IL-6, and IL-8. All data were analyzed on an intention-to-treat basis using appropriate statistical tests. RESULTS Random allocation of participants resulted in well-balanced control and test groups. All test group participants and all but one control participant gave birth to a live infant. No significant differences were detected between control and test groups with regard to birth outcome measures of birth weight and gestational age or in relation to cytokine prevalence/levels. CONCLUSION Intrapregnancy non-surgical periodontal treatment, completed at 20 to 24 weeks, did not reduce the risk of preterm, low-birth-weight delivery in this population.
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Affiliation(s)
- Martina Pirie
- Centre for Dental Education, School of Medicine, Dentistry, and Biomedical Sciences, Queens University, Belfast, Northern Ireland
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Moura da Silva G, Coutinho SB, Piscoya MDBV, Ximenes RAA, Jamelli SR. Periodontitis as a risk factor for preeclampsia. J Periodontol 2012; 83:1388-96. [PMID: 22309175 DOI: 10.1902/jop.2012.110256] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Periodontitis is an inflammatory process caused by a specific group of microorganisms, resulting in the destruction of the tooth-supporting tissue and the resorption of the alveolar bone. Therefore, periodontitis has been considered a risk factor for preeclampsia because infection is one of the factors involved in the etiology and pathogenesis of preeclampsia. The aim of the present study is to determine whether periodontitis is a risk factor for preeclampsia and to identify other possible risk factors. METHODS A case-control study was performed with 574 puerperae under care at the university hospital at the Universidade Federal de Pernambuco in the city of Recife, Brazil. Data collection was preceded by a training exercise and a pilot study. Biologic and socioeconomic data were collected along with medical and dental records. A periodontal examination was performed on all dental elements to determine probing depth and gingival recession. The association between periodontitis and preeclampsia was first adjusted for the variables within each block, and adjusted for the variables of all blocks in the final multivariate model. RESULTS The multivariate logistic regression analysis showed that, after adjustment for other risk factors, periodontitis remained an independent risk factor for preeclampsia (adjusted odds ratio [OR] = 8.60, confidence interval [CI] = 3.92 to 18.88, P < 0.001 and adjusted OR = 2.03, 95% CI = 1.43 to 2.90, P < 0.001, when using the Centers for Disease Control and Prevention/American Academy of Periodontology definition). CONCLUSION The results suggest that within the population studied, periodontitis was a risk factor for preeclampsia.
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Gordon SC, Kaste LM, Barasch A, Safford MM, Foong WC, ElGeneidy A. Prenuptial Dental Extractions in Acadian Women: First Report of a Cultural Tradition. J Womens Health (Larchmt) 2011; 20:1813-8. [DOI: 10.1089/jwh.2011.3074] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sara C. Gordon
- Department of Oral Medicine and Diagnostic Sciences and Department of Pathology, University of Illinois, Chicago, Illinois
| | - Linda M. Kaste
- Department of Pediatric Dentistry, University of Illinois, Chicago, Illinois
| | - Andrei Barasch
- Department of Dental Medicine, Winthrop University Hospital, Mineola, New York
| | - Monika M. Safford
- Department of Medicine, Division of Preventive Medicine, University of Alabama, Birmingham, Alabama
| | - W. Choong Foong
- Department of Biomedical and Diagnostic Sciences, University of Detroit Mercy, Detroit, Michigan
| | - Adry ElGeneidy
- Department of Biomedical and Diagnostic Sciences, University of Detroit Mercy, Detroit, Michigan
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The associations of parental under-education and unemployment on the risk of preterm birth: 2003 Korean National Birth Registration database. Int J Public Health 2011; 57:253-60. [DOI: 10.1007/s00038-011-0318-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2010] [Revised: 09/20/2011] [Accepted: 10/24/2011] [Indexed: 10/15/2022] Open
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Progesterone interactions with the cervix: translational implications for term and preterm birth. Infect Dis Obstet Gynecol 2011; 2011:353297. [PMID: 22114461 PMCID: PMC3206389 DOI: 10.1155/2011/353297] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 08/29/2011] [Indexed: 01/04/2023] Open
Abstract
The uterine cervix plays a vital role in maintaining pregnancy and an equally important role in allowing parturition to occur. Progesterone, either endogenously produced or supplied exogenously, supports the function of the cervix in sustaining intrauterine pregnancy, and the withdrawal of progesterone, either through natural processes or pharmacologic intervention, leads to delivery which underscores the importance of the progesterone's biological activities manifest in normal gestation and pregnancy that ends prematurely. Research crossing many scientific disciplines has demonstrated that progesterone is a pleotropic compound that affects the cervix through cytoplasmic and membrane receptors with profound effects on cellular and molecular functions that influence inflammatory cascades and extracellular matrix, both of which have consequences for parturition. Beyond the local cell and molecular biology of progesterone, it has systemic effects of relevance to pregnancy as well. This paper examines the biology of the cervix from its gross to cellular structure and biological activities of its cell and molecular processes that may be affected by progesterone. The implications of these processes for preterm birth are explored, and direction of current research is in relation to translational medicine implications for diagnostic, prognostic, and therapeutic approaches to threatened preterm birth.
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Giannella L, Giulini S, Cerami LB, La Marca A, Forabosco A, Volpe A. Periodontal disease and nitric oxide levels in low risk women with preterm labor. Eur J Obstet Gynecol Reprod Biol 2011; 158:47-51. [DOI: 10.1016/j.ejogrb.2011.04.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 03/26/2011] [Accepted: 04/28/2011] [Indexed: 01/12/2023]
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Schenkein HA, Koertge TE, Sabatini R, Brooks CN, Gunsolley JC. Birth weight of infants of mothers with aggressive periodontitis. J Periodontol 2011; 83:279-86. [PMID: 21819247 DOI: 10.1902/jop.2011.110192] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND It was hypothesized that if periodontal infections predispose low birth weights and premature birth, then such outcomes should be apparent when the mother has aggressive periodontitis (AgP). METHODS Birth weight data were collected by questionnaire from females with AgP, their periodontally healthy siblings, and unrelated periodontally healthy women. Both prospective and retrospective birth outcome data were used. Because many of the periodontal evaluations were performed after the births, there were incomplete data regarding most of the risk factors for low birth weight. We determined associations between mothers' periodontal diagnoses and clinical variables and the reported birth weights. RESULTS There were no significant differences in mean birth weights of babies born to control subjects or AgP patients. This was true whether all the births were considered or only those reported <1 or 2 years before periodontal examination. For periodontally healthy controls, 13.2% of babies born to siblings of AgP patients and 12.8% of babies born to unrelated mothers weighed <2,500 g, whereas 9.9% of those born to mothers with generalized AgP and 10.3% of those born to mothers with localized AgP weighed <2,500 g. CONCLUSIONS Because of the relative rarity of AgP in the population, and attendant difficulties in performing a prospective study of its association with pregnancy outcomes, we used a compromised approach using prospective data as well as weaker retrospective data assuming that disease onset was likely before the births. Our results, within the limitations of this approach, indicate no evidence that AgP in the mother predisposes low birth weights. AgP has many unique biologic characteristics that differentiate it from chronic forms of periodontal disease, and the possible lack of its association with birth weight may be another such characteristic.
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Affiliation(s)
- Harvey A Schenkein
- Department of Periodontics, Virginia Commonwealth University, School of Dentistry, Richmond, VA 23298-0566, USA.
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Periodontal disease as a risk factor for adverse pregnancy outcomes: a systematic review and meta-analysis of case–control studies. Odontology 2011; 100:232-40. [DOI: 10.1007/s10266-011-0036-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 06/09/2011] [Indexed: 11/26/2022]
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ANOTHER VIEWPOINT: Authors’ response to Dr. Rethman, Dr. Speiser and Dr. Jeffcoat. J Am Dent Assoc 2011. [DOI: 10.14219/jada.archive.2011.0211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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