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Ajeeb TT, Gonzalez E, Solomons NW, Vossenaar M, Koski KG. Human milk microbiome: associations with maternal diet and infant growth. Front Nutr 2024; 11:1341777. [PMID: 38529196 PMCID: PMC10962684 DOI: 10.3389/fnut.2024.1341777] [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: 11/20/2023] [Accepted: 02/22/2024] [Indexed: 03/27/2024] Open
Abstract
Introduction Ingestion of human milk (HM) is identified as a significant factor associated with early infant gut microbial colonization, which has been associated with infant health and development. Maternal diet has been associated with the HM microbiome (HMM). However, a few studies have explored the associations among maternal diet, HMM, and infant growth during the first 6 months of lactation. Methods For this cross-sectional study, Mam-Mayan mother-infant dyads (n = 64) were recruited from 8 rural communities in the Western Highlands of Guatemala at two stages of lactation: early (6-46 days postpartum, n = 29) or late (109-184 days postpartum, n = 35). Recruited mothers had vaginally delivered singleton births, had no subclinical mastitis or antibiotic treatments, and breastfed their infants. Data collected at both stages of lactation included two 24-h recalls, milk samples, and infant growth status indicators: head-circumference-for-age-z-score (HCAZ), length-for-age-z-score (LAZ), and weight-for-age-z-score (WAZ). Infants were divided into subgroups: normal weight (WAZ ≥ -1SD) and mildly underweight (WAZ < -1SD), non-stunted (LAZ ≥ -1.5SD) and mildly stunted (LAZ < -1.5SD), and normal head-circumference (HCAZ ≥ -1SD) and smaller head-circumference (HCAZ < -1SD). HMM was identified using 16S rRNA gene sequencing; amplicon analysis was performed with the high-resolution ANCHOR pipeline, and DESeq2 identified the differentially abundant (DA) HMM at the species-level between infant growth groups (FDR < 0.05) in both early and late lactation. Results Using both cluster and univariate analyses, we identified (a) positive correlations between infant growth clusters and maternal dietary clusters, (b) both positive and negative associations among maternal macronutrient and micronutrient intakes with the HMM at the species level and (c) distinct correlations between HMM DA taxa with maternal nutrient intakes and infant z-scores that differed between breast-fed infants experiencing growth faltering and normal growth in early and late lactation. Conclusion Collectively, these findings provide important evidence of the potential influence of maternal diet on the early-life growth of breastfed infants via modulation of the HMM.
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Affiliation(s)
- Tamara T. Ajeeb
- School of Human Nutrition, McGill University, Montreal, QC, Canada
- Department of Clinical Nutrition, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Emmanuel Gonzalez
- Canadian Centre for Computational Genomics, McGill Genome Centre, Montreal, QC, Canada
- Department of Human Genetics, McGill University, Montreal, QC, Canada
- Gerald Bronfman Department of Oncology, McGill University, Montreal, QC, Canada
| | - Noel W. Solomons
- Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Guatemala City, Guatemala
| | - Marieke Vossenaar
- Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Guatemala City, Guatemala
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Díaz-Goñi V, Cavero-Redondo I, Bizzozero-Peroni B, Rodríguez-Gutiérrez E, Pascual-Morena C, Sequí-Domínguez I, Lucas-Torres ML, de Arenas-Arroyo SN, Saz-Lara A. Comparative effect of different types of physical exercise and intensity levels on low birth weight: A systematic review and network meta-analysis. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241276253. [PMID: 39320857 PMCID: PMC11425745 DOI: 10.1177/17455057241276253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 07/11/2024] [Accepted: 07/18/2024] [Indexed: 09/26/2024]
Abstract
BACKGROUND Low birth weight (LBW) has been established as a major determinant of neonatal mortality and morbidity. However, there is no evidence of the effectiveness of different types of physical exercise (PE) at different intensities during pregnancy to prevent LBW. OBJECTIVES To compare the effectiveness of different types of PE at different levels of intensity in pregnant women to prevent LBW. DESIGN A systematic review and network meta-analysis was performed according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols for Network Meta-Analysis extension statement. DATA SOURCES AND METHODS We searched the PubMed, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science databases from inception to November 2023. We included randomized controlled trials (RCTs). A random effects method was used to calculate the pooled mean difference (MD). The effect of each intervention was calculated using a network meta-analysis with a frequentist perspective. RESULTS Forty-three RCTs were included in the systematic review, and 38 RCTs were included in the network meta-analysis. In the general population, although no significant results, the MDs for light-moderate strength, moderate-vigorous strength, and moderate-vigorous Pilates exercises were favorable for preventing LBW. Furthermore, moderate-vigorous strength exercise was effective to prevent LBW, reporting significant MD compared to control groups in the healthy population (310.00, 95% confidence interval: 78.40, 541.60; I2 = 81.3%). CONCLUSION Strength exercises at a moderate-vigorous intensity could be a potential strategy for the prevention of LBW in the healthy population. However, our findings should be interpreted with caution because the overall risk of bias was between "some concerns" and "high," and the overall certainty of the evidence was low. REGISTRATION PROSPERO CRD42023401770.
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Affiliation(s)
- Valentina Díaz-Goñi
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Iván Cavero-Redondo
- CarVasCare Research Group (2023-GRIN-34459), Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Bruno Bizzozero-Peroni
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain
- Higher Institute of Physical Education, Universidad de la República, Rivera, Uruguay
| | - Eva Rodríguez-Gutiérrez
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain
| | - Carlos Pascual-Morena
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain
- Faculty of Nursing of Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Irene Sequí-Domínguez
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain
- Faculty of Nursing of Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | | | | | - Alicia Saz-Lara
- CarVasCare Research Group (2023-GRIN-34459), Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
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Wen X, Fu X, Zhao C, Yang L, Huang R. The bidirectional relationship between periodontal disease and pregnancy via the interaction of oral microorganisms, hormone and immune response. Front Microbiol 2023; 14:1070917. [PMID: 36778874 PMCID: PMC9908602 DOI: 10.3389/fmicb.2023.1070917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023] Open
Abstract
Periodontal disease has been suggested to be linked to adverse pregnancy outcomes such as preterm birth, low birth weight, and preeclampsia. Adverse pregnancy outcomes are a significant public health issue with important clinical and societal repercussions. This article systematically reviews the available epidemiological studies involving the relationship between periodontal disease and adverse pregnancy outcomes over the past 15 years, and finds a weak but independent association between adverse pregnancy outcomes and periodontal disease. The bidirectional association and the potential mechanisms are then explored, focusing on three possible mechanisms: inflammatory reaction, oral microorganisms and immune response. Specifically, elevated systemic inflammation and increased periodontal pathogens with their toxic products, along with a relatively suppressed immune system may lead to the disruption of homeostasis within fetal-placental unit and thus induce adverse pregnancy outcomes. This review also explains the possible mechanisms around why women are more susceptible to periodontal disease. In conclusion, pregnant women are more likely to develop periodontal disease due to hormonal changes, and periodontal disease has also been suspected to increase the incidence of adverse pregnancy outcomes. Therefore, in order to lessen the risk of adverse pregnancy outcomes, both obstetricians and dentists should pay attention to the development of periodontal diseases among women during pregnancy.
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Belardi BE, Mattera MSDLC, Tsosura TVS, Dos Santos RM, Cantiga da Silva C, Tavares Ângelo Cintra L, Chiba FY, Bravo LT, Carvalho NR, Carnevali AC, de Oliveira RAF, Ervolino E, Matsushita DH. Effect of maternal true combined endodontic-periodontal lesion on insulin and inflammatory pathway in adult offspring. J Periodontol 2022; 94:487-497. [PMID: 35994367 DOI: 10.1002/jper.22-0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/29/2022] [Accepted: 08/11/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Maternal periodontal disease (PED) and apical periodontitis (AP) are associated insulin resistance (IR), increased tumor necrosis factor-α (TNF-α) levels, and alterations in insulin signaling (IS) in the gastrocnemius muscle (GM) of adult offspring. TNF-α stimulates I kappa B kinase (IKK) and c-Jun N-terminal protein kinase (JNK), resulting in IS attenuation. However, studies that investigated the maternal true endodontic-periodontal lesion (EPL) in offspring are scarce, and in this case, the impact could be even higher. This study aimed to evaluate the effects of EPL on the IR, IS, and inflammatory pathways on the offspring GM. METHODS Female Wistar rats were distributed into control, AP, PED, and EPL groups. After 30 days of oral inflammation induction, rats from all groups were allowed to mate with healthy rats. The bodyweight of the offspring was assessed from birth to 75 days of age. After 75 days, the following measurements were performed: glycemia, insulinemia, IR, TNF-α content, and IKKα/β, JNK, pp185 (Tyr), and IRS-1 (Ser) phosphorylation status in the GM. RESULTS Maternal PED and EPL were associated with low birth weights. All maternal oral inflammations promoted IR and IS impairment in the GM and only maternal PED and EPL caused an increase in TNF-α content and IKKα/β phosphorylation status in the GM of offspring. The EPL-o group showed worsening of metabolic changes when compared to offspring of rats with AP or PED. CONCLUSION Association of maternal AP and PED promoted a more pronounced worsening in the health of the adult offspring. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Bianca Elvira Belardi
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas-SBFis, Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Maria Sara de Lima Coutinho Mattera
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas-SBFis, Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Thaís Verônica Saori Tsosura
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas-SBFis, Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Rodrigo Martins Dos Santos
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas-SBFis, Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Cristiane Cantiga da Silva
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (unesp), Araçatuba, Brazil
| | - Luciano Tavares Ângelo Cintra
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (unesp), Araçatuba, Brazil
| | - Fernando Yamamoto Chiba
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (unesp), Araçatuba, Brazil
| | - Lara Teschi Bravo
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (unesp), Araçatuba, Brazil
| | - Nubia Ramos Carvalho
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas-SBFis, Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Ana Carolina Carnevali
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas-SBFis, Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Renan Akira Fujii de Oliveira
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (unesp), Araçatuba, Brazil
| | - Edilson Ervolino
- Institute of Biosciences, Botucatu, Brazil and Department of Basic Sciences, Division of Histology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Doris Hissako Matsushita
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas-SBFis, Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
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Porto ECL, Gomes Filho IS, Batista JET, Lyrio AO, Souza ES, Figueiredo ACMG, Pereira MG, Cruz SSD. [Maternal periodontitis and low birth weight: systematic review and meta-analysis]. CIENCIA & SAUDE COLETIVA 2021; 26:5383-5392. [PMID: 34787227 DOI: 10.1590/1413-812320212611.3.32362019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/20/2020] [Indexed: 11/22/2022] Open
Abstract
Recent evidence points to the influence of periodontal inflammatory processes on the occurrence of low birth weight. Although many studies employed robust investigation methods, there is still no general agreement on the relationship between maternal periodontitis and low birth weight. The search for studies was conducted until April 2019. The studies included cohort and case-control studies that estimated the association between periodontitis and low birth weight, with no restriction on language or date of publication. Analysis of the heterogeneity of studies, subgroup analyses and meta-analyses with a random effects model were performed. Summary association measurements were estimated using the crude and adjusted Odds Ratio, with respective 95% confidence intervals. Visual inspection of graphs was used to assess publication bias. A total of 21 articles were identified, all of which were selected for the meta-analysis. The final model indicates that periodontitis in pregnant women was associated with low birth weight (ORgross=2.13; CI95%=1.60-2.83; I2=80.0% and ORadjusted=2.64; CI95%=2.04-3.42; I2=17.4%). Pregnant women with periodontitis may be more than twice as likely to have low birth weight babies.
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Affiliation(s)
- Edla Carvalho Lima Porto
- Universidade Estadual de Feira de Santana. Av. Transnordestina s/n, Feira de Santana. 44036-900 Novo Horizonte BA Brasil.
| | - Isaac Suzart Gomes Filho
- Universidade Estadual de Feira de Santana. Av. Transnordestina s/n, Feira de Santana. 44036-900 Novo Horizonte BA Brasil.
| | - Josicélia Estrela Tuy Batista
- Universidade Estadual de Feira de Santana. Av. Transnordestina s/n, Feira de Santana. 44036-900 Novo Horizonte BA Brasil.
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Factors Related to Maternal Oral Health Status: Focus on Pregnant and Breastfeeding Women. Healthcare (Basel) 2021; 9:healthcare9060708. [PMID: 34200724 PMCID: PMC8229509 DOI: 10.3390/healthcare9060708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 11/16/2022] Open
Abstract
Oral health management is vital for pregnant women and their fetuses. This study analyzed the factors affecting maternal oral health status. It used secondary data obtained from the 2019 Korean Community Health Survey. Data were analyzed using SPSS 21.0 for complex descriptive statistics, independent t-test, Pearson’s correlation coefficients, and multiple regression analysis. Multiple regression analysis revealed that age (β = −0.01, p < 0.001), maternal characteristics (β = −0.10, p < 0.001), education (β = −0.06, p = 014), subjective health status (β = 0.27, p < 0.001, sleep duration (β = 0.07, p = 0.003), breakfast frequency (β = −0.16, p < 0.001), unmet dental care needs (β = 0.35, p < 0.001), and depression (β = −0.02, p < 0.001) are key factors of maternal oral health status. Furthermore, oral health status is associated with mental health factors, such as depression. Therefore, the importance of maternal oral health among pregnant and breastfeeding women must be highlighted to promote the health of mothers and their babies.
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Jyotirmay, Kumar A, Gulati S, Kumari S, Nazeer J, Singh P. Association of maternal periodontal health with preterm birth and a low birth weight among newborns: A cross-sectional study. Natl J Maxillofac Surg 2021; 12:67-71. [PMID: 34188403 PMCID: PMC8191548 DOI: 10.4103/njms.njms_135_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/10/2020] [Accepted: 10/07/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Despite numerous advancements in prenatal and natal care, complications arising in pregnancy and related to child-birth are major concerns in public health. Various risk factors responsible for poor outcomes include - life-style, biological, social, infectious, hormonal, and metabolic conditions. Oral diseases have been identified as a risk factor for low birth weight both under preterm and at-term states. AIM The aim of this study was to find an association of maternal periodontal health with preterm births and low birth weight among newborn infants. MATERIALS AND METHODS This was a cross-sectional observational study comprising of 300 pregnant females who had underwent child deliveries within the past 24 h with an age range of 21-30 years. Study participants were selected after interviewing for gestational history and obtaining prior informed consent. Postpartum female subjects following delivery within a time period of 24 h were included in the study. Gingival index (by Loe and Silness) was calculated for the evaluation of bleeding from gingival tooth surfaces. All data tabulations were done by performing statistical analysis into Microsoft Excel Worksheet 2007. RESULTS Mean age group of study participants was calculated to be 25 years. On analyzing brushing frequency, it was observed that approximately 40% brushed three times daily whereas 35% used to brush twice daily while the remaining, 25% brushed only once daily. No statistical significance was obtained on comparing brushing frequency with gingival health (P = 0.8). Similarly, no association was found between periodontal health and preterm low weight child births. CONCLUSION This study found no association between maternal periodontal health and preterm and low-birth weight births among newborns.
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Affiliation(s)
- Jyotirmay
- Department of Orthodontics, Patna Dental College and Hospital, Patna, Bihar, India
| | - Amit Kumar
- Dental Officer, Sub Divisional Hospital, Forbesganj, Araria, Bihar, India
| | - Saakshi Gulati
- Department of Oral Medicine and Radiology, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Stuti Kumari
- Department of Dentistry, SKMCH, Muzaffarpur, Bihar, India
| | - Jazib Nazeer
- Department of Oral Pathology and Microbiology, Patna Dental College and Hospital, Patna, Bihar, India
| | - Pankaj Singh
- Department of Conservative Dentistry and Endodontics, Patna Dental College and Hospital, Patna, Bihar, India
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Rosa L, Lepanto MS, Cutone A, Ianiro G, Pernarella S, Sangermano R, Musci G, Ottolenghi L, Valenti P. Lactoferrin and oral pathologies: a therapeutic treatment. Biochem Cell Biol 2020; 99:81-90. [PMID: 32213143 DOI: 10.1139/bcb-2020-0052] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The oral cavity is a non-uniform, extraordinary environment characterized by mucosal, epithelial, abiotic surfaces and secretions as saliva. Aerobic and anaerobic commensal and pathogenic microorganisms colonize the tongue, teeth, jowl, gingiva, and periodontium. Commensals exert an important role in host defenses, while pathogenic microorganisms can nullify this protective function causing oral and systemic diseases. Every day, 750-1000 mL of saliva, containing several host defense constituents including lactoferrin (Lf), are secreted and swallowed. Lf is a multifunctional iron-chelating cationic glycoprotein of innate immunity. Depending on, or regardless of its iron-binding ability, Lf exerts bacteriostatic, bactericidal, antibiofilm, antioxidant, antiadhesive, anti-invasive, and anti-inflammatory activities. Here, we report the protective role of Lf in different oral pathologies, such as xerostomia, halitosis, alveolar or maxillary bone damage, gingivitis, periodontitis, and black stain. Unlike antibiotic therapy, which is ineffective against bacteria that are within a biofilm, adherent, or intracellular, the topical administration of Lf, through its simultaneous activity against microbial replication, biofilms, adhesion, and invasiveness, as well as inflammation, has been proven to be efficient in the treatment of all known oral pathologies without any adverse effects.
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Affiliation(s)
- Luigi Rosa
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | | | - Antimo Cutone
- Department of Biosciences and Territory, University of Molise, Pesche, Italy
| | - Giusi Ianiro
- Department of Biosciences and Territory, University of Molise, Pesche, Italy
| | - Stefania Pernarella
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy
| | - Riccardo Sangermano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Giovanni Musci
- Department of Biosciences and Territory, University of Molise, Pesche, Italy
| | - Livia Ottolenghi
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy
| | - Piera Valenti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
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Basuki W, Rawlinson J, Lothamer C, Wheeler R, Prytherch B. Evaluation of Gingivitis in Pregnant Beagle Dogs. J Vet Dent 2020; 36:179-185. [DOI: 10.1177/0898756419892202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Periodontal disease (PD) in pregnant women has been correlated with negative impacts on pregnancy outcomes including low birth weight, preterm labor, and increased neonatal mortality. This study aimed to explore similar associations in dogs. Medical, dental, and reproductive records of healthy female beagles producing one or more litters within a research breeding facility were evaluated over a 1.5-year period. Dental scoring (1-6) was based on a facility-developed, subjective assessment of gingivitis and calculus deposition following parturition. Assessment of periodontitis was not performed. Statistical analyses were performed to find correlations between the dam’s dental score and pregnancy outcomes (length of gestation, litter size, stillborn, and failure to thrive puppies). Dam age, litter size, and perinatal mortalities were controlled in the statistical models. Data were collected from 808 dams, 1344 litters, and 7197 puppies; 75.3% of the 1344 dam scores were categorized as dental score 3 or less with a mean of 2.7. None of the evaluated pregnancy outcomes had any significant correlations with the severity of dental scores. The lack of a significant relationship between dental score and pregnancy outcomes may be the result of the low number of dogs with severe gingivitis and calculus deposition, the variability of dental score timing postparturition, and/or the subjective facility-generated dental scoring method that did not include universally accepted methods for gingivitis and periodontitis assessment. Studies involving more animals with severe PD utilizing objective, universally accepted methods for gingivitis and periodontitis assessment are warranted to say with confidence no association exists.
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Affiliation(s)
- Williana Basuki
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Jennifer Rawlinson
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Chad Lothamer
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Richard Wheeler
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Ben Prytherch
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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Preventive hygiene protocol of University of Milan for women during pregnancy: A qualitative and quantitative bacterial plaque analysis prospective original study. Saudi Dent J 2020; 32:29-35. [PMID: 31920276 PMCID: PMC6950842 DOI: 10.1016/j.sdentj.2019.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/17/2019] [Accepted: 05/20/2019] [Indexed: 11/26/2022] Open
Abstract
Introduction The aim of this article is to describe the preventive hygiene protocol of University of Milan for women during pregnancy analyzing the bacterial plaque quantitatively and qualitatively. Materials and methods A sample of 35 pregnant women following a protocol of periodic visits starting from the first month of pregnancy until the childbirth and in follow up controls were analyzed. Several samples (n = 4) of bacterial plaque for quantitative and qualitative analysis were taken, from the lingual surface of the lower first molar, during the first visit (T0), during the first trimester (T1), during the second or third trimester of pregnancy (T2), and one month after childbirth (T3). Results By performing a quantitative analysis, it was calculated that the average plaque index (Fig. 1) was n = 48.1% (T0), n = 14.7% (T1), n = 18.4% (T2) and n = 18.9% (T3). The plaque index score presents a downward trend, passing from 48.1% (T0) to 18.9% (T3). The number of total cocci (Fig. 2) was n = 205.39 (T0), n = 57.5(T1), n = 74.6 (T2) and n = 75.4(T3). The number of total bacilli (Fig. 3) was n = 62.7 (T0), n = 23.1 (T1), n = 25.3 (T2), n = 27.1(T3). The total values of cocci and bacilli were correlated and the average trend of the various samples was calculated. By performing a qualitative analysis, the value of G+ cocci (Fig. 5) was n = 2.7 (T0), n = 1.4 (T1), n = 1.4 (T2) and n = 1.5 (T3). The value of G− cocci (Fig. 5) was n = 2.3 (T0), n = 0.7 (T1), n = 1.1 (T2) and n = 1.1 (T3). The value of G+ bacilli (Fig. 6) was n = 1.6 (T0), n = 0.9 (T1), n = 1.2 (T2) and n = 1.2 (T3). The value of G− bacilli (Fig. 6) was n = 1.3 (T0), n = 0.3 (T1), n = 0.7 (T2) and n = 0.7 (T3). Conclusions The preventive hygiene protocol used in the Dental Hygiene Department of the University of Milan, during the gestation period, is a suitable method for the control of the bacterial plaque. A considerably decrease of the plaque index and bacterial components between the first visit and the subsequent check-ups was calculated.
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Poulsen H, Meurman JH, Kautiainen H, Heikkinen AM, Huvinen E, Koivusalo S, Eriksson JG. Oral Health in Women with a History of High Gestational Diabetes Risk. Dent J (Basel) 2019; 7:E92. [PMID: 31484379 PMCID: PMC6784739 DOI: 10.3390/dj7030092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/21/2019] [Accepted: 08/27/2019] [Indexed: 12/21/2022] Open
Abstract
We studied oral health in 115 women with and without a history of gestational diabetes (GDM), expecting poorer oral health in the GDM group. Full-mouth examinations were performed 5 years postpartum and the number of teeth, total dental index (TDI) and decayed, missing, filled teeth (DMFT) index were calculated. Bleeding on probing (BOP), probing depth (PD), visible plaque index (VPI), and clinical attachment level (CAL) were recorded. The periodontal inflammatory burden index (PIBI) was calculated. Panoramic radiographs were taken and signs of infections recorded. Oral health habits, symptoms and participants' own opinion of oral health were recorded with questionnaires. At the time of examination, 45% of the women had a history of GDM in the index pregnancy. Mild periodontitis (62%) and bleeding on probing (46%) were common. VPI (13% and 17%, p = 0.009) and PIBI (13.1 and 17.5, p = 0.041) were lower among women with a history of GDM compared with those with no history of GDM. There was no difference between groups in DMFT scores. All women reported good subjective oral health. Thus, contrary to our hypothesis, women with a history of GDM showed better oral health parameters than women without a history of GDM.
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Affiliation(s)
- Hanna Poulsen
- Department of Oral and Maxillofacial Diseases and Helsinki University Hospital, University of Helsinki, PB 700, 00029 HUS, Finland.
| | - Jukka H Meurman
- Department of Oral and Maxillofacial Diseases and Helsinki University Hospital, University of Helsinki, PB 700, 00029 HUS, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, PO Box 20, 00014 Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland
| | - Anna Maria Heikkinen
- Department of Oral and Maxillofacial Diseases and Helsinki University Hospital, University of Helsinki, PB 700, 00029 HUS, Finland
| | - Emilia Huvinen
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, PO Box 140, 00029 HUS, Helsinki, Finland
| | - Saila Koivusalo
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, PO Box 140, 00029 HUS, Helsinki, Finland
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, PO Box 20, 00014 Helsinki, Finland
- Folkhälsan Research Center, University of Helsinki, PO Box 20, 00014 Helsinki, Finland
- Department of Obstetrics and Gynecology, National University Singapore, Yong Loo Lin School of Medicine, 1E Kent Ridge Road, Singapore 119228, Singapore
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12
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Valadbeigi T, Tabatabaee HR, Etemad K, Keyghobadi N, Mahdavi S, Enayatrad M, Saeidinejat S, Yaghoobi H, Zolfizadeh F, Ghasemi A, Hajipour M. The association between low birth weight and mothers diseases in Iran: A case-control study. J Neonatal Perinatal Med 2019; 12:449-456. [PMID: 31256076 DOI: 10.3233/npm-180068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Neonates are too vulnerable that low birth weight (LBW) and preterm birth can easily threaten their lives. Demographic, social and environmental factors as well as health care are contributing factors for LBW. The study was conducted in 10 provinces of Iran to investigate the association between LBW and mother's diseases. METHODS A case-control study was conducted in 10 provinces of Iran on 2580 mothers (712 cases and 1868 controls) referred to public health care centers. We used a questionnaire to collect data. For univariate analysis we used chi-square test and for multivariable analysis we used logistic regression model. RESULTS LBW was significantly associated with living in rural area (OR = 1.4 CI: 1.14-1.71), having body mass index (BMI)<18 (OR = 1.48 CI: 1.14-1.92), being a housewife (OR = 1.65 CI: 1.07-2.53), having high blood pressure (OR = 1.91 CI: 1.26-2.88), and having pregnancy without testing for diabetes (OR = 1.91 CI: 1.44-2.54). Minor thalassemia, hypothyroidism, oral health care and headache were not significant predictors for LBW. CONCLUSION In this study, we observed that place of residence, BMI before pregnancy, mother's occupation and gestational diabetes were significant predictors of LBW. It is necessary to improve women's awareness about prenatal health care before pregnancy to avoid LBW.
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Affiliation(s)
- T Valadbeigi
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | - H Reza Tabatabaee
- Department of Epidemiology, Research Center for Health Sciences, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - K Etemad
- Department of Epidemiology, Environmental and Occupational Hazards Control Research Center, Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - N Keyghobadi
- Department of Biostatistics Epidemiology, Health Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - S Mahdavi
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | - M Enayatrad
- Department of Epidemiology, Dezful University of Medical Sciences, Dezful, Iran
| | - S Saeidinejat
- Department of Health Education and Health Promotion, School of Health Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - H Yaghoobi
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - F Zolfizadeh
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - A Ghasemi
- Birjand University of Medical Sciences, Birjand, Iran
| | - M Hajipour
- Student research committee, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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13
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Hans M, Hans VM, Kahlon N, Ramavat PKR, Gupta U, Das A. Oral health awareness and practices in pregnant females: A hospital-based observational study. J Indian Soc Periodontol 2019; 23:264-268. [PMID: 31143008 PMCID: PMC6519098 DOI: 10.4103/jisp.jisp_372_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: The aim of this study was to assess the oral health awareness, methods adopted to maintain hygiene, prevalent myths regarding oral health in pregnancy, and importance of oral health during pregnancy, to help formulate oral health program for pregnant females in partaking hospital. Materials and Methods: A total of 225 pregnant females participated in the study. After complete demographic assessment of participants, a questionnaire was provided to them. Questionnaire included simple multiple choice questions on how they maintained oral hygiene, their oral health status, visit to the dentist, and barriers in seeking treatment. This was followed by a questionnaire regarding common myths and understanding of the importance of oral health during pregnancy which had three choices: true, false, and do not know. The results were expressed in percentages, and one sample t-test for percentages was applied where ever required. Results: Majority of participants self-reported some form of oral health problems with bleeding gums as a chief complaint leading the survey. Around half of the participants had never visited a dentist, and an abundant number of pregnant females reported safety concerns for developing the child as a reason for not taking any treatment during pregnancy. A highly significant number of participants were unaware of the importance of oral health during pregnancy and believed in age-old myths. Conclusion: The oral health care still remains on the backseat in care provided to pregnant female. A complete overhaul of understanding through individual, family, and community counseling is required to spread awareness.
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Affiliation(s)
- Mayank Hans
- Department of Dentistry, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Veenu Madaan Hans
- Department of Dentistry, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Namrata Kahlon
- Department of Physiology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | | | - Usha Gupta
- Department of Obstetrics and Gynecology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Asim Das
- Department of Physiology, ESIC Medical College and Hospital, Faridabad, Haryana, India
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14
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Tsosura TVS, Chiba FY, Mattera MSLC, Pereira RF, Cintra LTA, Conti LC, Santos RMD, Mateus JHP, Garbin CAS, Sumida DH. Maternal apical periodontitis is associated with insulin resistance in adult offspring. Int Endod J 2019; 52:1040-1050. [DOI: 10.1111/iej.13096] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 02/11/2019] [Indexed: 12/19/2022]
Affiliation(s)
- T. V. S. Tsosura
- Department of Basic Sciences Multicenter Postgraduate Program in Physiological Sciences SBFisSchool of Dentistry São Paulo State University (UNESP) Araçatuba Brazil
| | - F. Y. Chiba
- Department of Children and Social DentistrySchool of Dentistry São Paulo State University (UNESP) Araçatuba Brazil
| | - M. S. L. C. Mattera
- Department of Basic Sciences Multicenter Postgraduate Program in Physiological Sciences SBFisSchool of Dentistry São Paulo State University (UNESP) Araçatuba Brazil
| | - R. F. Pereira
- Department of Basic Sciences Multicenter Postgraduate Program in Physiological Sciences SBFisSchool of Dentistry São Paulo State University (UNESP) Araçatuba Brazil
| | - L. T. A. Cintra
- Department of Restorative Dentistry School of Dentistry São Paulo State University (UNESP) Araçatuba Brazil
| | - L. C. Conti
- Department of Restorative Dentistry School of Dentistry São Paulo State University (UNESP) Araçatuba Brazil
| | - R. M. dos Santos
- Department of Basic Sciences Multicenter Postgraduate Program in Physiological Sciences SBFisSchool of Dentistry São Paulo State University (UNESP) Araçatuba Brazil
| | - J. H. P. Mateus
- Department of Basic Sciences Multicenter Postgraduate Program in Physiological Sciences SBFisSchool of Dentistry São Paulo State University (UNESP) Araçatuba Brazil
| | - C. A. S. Garbin
- Department of Children and Social DentistrySchool of Dentistry São Paulo State University (UNESP) Araçatuba Brazil
| | - D. H. Sumida
- Department of Basic Sciences Multicenter Postgraduate Program in Physiological Sciences SBFisSchool of Dentistry São Paulo State University (UNESP) Araçatuba Brazil
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15
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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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16
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Mattera MSDLC, Chiba FY, Lopes FL, Tsosura TVS, Peres MA, Brito VGB, Oliveira SHP, Pereira RF, Marani F, dos Santos RM, Belardi BE, Tessarin GWL, Benites ML, Ervolino E, Heimann JC, Sumida DH. Effect of maternal periodontitis on GLUT4 and inflammatory pathway in adult offspring. J Periodontol 2019; 90:884-893. [DOI: 10.1002/jper.18-0568] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/02/2019] [Accepted: 01/08/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Maria Sara de Lima Coutinho Mattera
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Fernando Yamamoto Chiba
- Department of Child and Social DentistrySchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | | | - Thaís Verônica Saori Tsosura
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Maria Angelica Peres
- Department of Internal MedicineLaboratory of Experimental Hypertension, School of Medicine, University of São Paulo São Paulo Brazil
| | - Victor Gustavo Balera Brito
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Sandra Helena Penha Oliveira
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Renato Felipe Pereira
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Fernando Marani
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Rodrigo Martins dos Santos
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Bianca Elvira Belardi
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Gestter Willian Lattari Tessarin
- Institute of BiosciencesSão Paulo State University (UNESP) Botucatu Brazil
- Department of Basic SciencesDivision of HistologyDental School of AracatubaUNESP‐Univ Estadual Paulista Araçatuba Brazil
| | - Mariana Lopes Benites
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
| | - Edilson Ervolino
- Institute of BiosciencesSão Paulo State University (UNESP) Botucatu Brazil
- Department of Basic SciencesDivision of HistologyDental School of AracatubaUNESP‐Univ Estadual Paulista Araçatuba Brazil
| | - Joel Claudio Heimann
- Department of Internal MedicineLaboratory of Experimental Hypertension, School of Medicine, University of São Paulo São Paulo Brazil
| | - Doris Hissako Sumida
- Multicenter Post‐Graduate Program in Physiological Sciences (SBFis)Department of Basic SciencesSchool of DentistrySão Paulo State University (UNESP) Araçatuba Brazil
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17
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Chanomethaporn A, Chayasadom A, Wara-Aswapati N, Kongwattanakul K, Suwannarong W, Tangwanichgapong K, Sumanonta G, Matangkasombut O, Dasanayake AP, Pitiphat W. Association between periodontitis and spontaneous abortion: A case-control study. J Periodontol 2018; 90:381-390. [PMID: 30367824 DOI: 10.1002/jper.18-0174] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Spontaneous abortion, or miscarriage, is a complication of pregnancy which can severely affect women both physically and psychologically. We investigated the associations of periodontitis and periodontopathic bacteria with spontaneous abortion. METHODS We conducted a matched case-control study in two tertiary hospitals in Khon Kaen, Thailand. Cases were 85 women with spontaneous abortion at <20 weeks of gestation matched to 85 controls on age, gestational age, and hospital. Full-mouth periodontal examinations were performed. Periodontitis was defined as at least one site with probing depth ≥5 mm and clinical attachment level ≥2 mm at the same site. Subgingival plaque samples were collected to determine the levels of Porphyromonas gingivalis, Tannerella forsythia, and Fusobacterium nucleatum using real time polymerase chain reaction. RESULTS The cases were significantly more likely to have periodontitis (50.6%) than the controls (21.2%; P = 0.007). Conditional logistic regression revealed a crude odds ratio (OR) of 4.1 for the association between periodontitis and spontaneous abortion (95% confidence interval [CI] = 1.9-8.9, P = 0.001). The OR decreased, but was still significant, after controlling for previous miscarriage (OR = 3.3, 95% CI = 1.4-7.8, P = 0.006). There was no significant association between the levels of periodontopathic bacteria and spontaneous abortion. Increased levels of P. gingivalis and F. nucleatum were associated with periodontitis in both case and control groups. Association between increased T. forsythia levels and periodontitis was observed only in the case women. CONCLUSIONS Periodontitis was more common in women with spontaneous abortions as compared with matched controls. Levels of periodontopathic bacteria was not associated with spontaneous abortion in this population.
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Affiliation(s)
- Anchana Chanomethaporn
- Department of Periodontology, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Anek Chayasadom
- Department of Periodontology, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Nawarat Wara-Aswapati
- Department of Periodontology, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand.,Chronic Inflammatory Diseases and Systemic Diseases Associated with Oral Health Research Group, Khon Kaen University
| | | | - Waraporn Suwannarong
- Department of Periodontology, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | | | | | - Oranart Matangkasombut
- Department of Microbiology and Research Unit on Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Ananda P Dasanayake
- Department of Epidemiology, New York University College of Dentistry, New York, NY, USA
| | - Waranuch Pitiphat
- Chronic Inflammatory Diseases and Systemic Diseases Associated with Oral Health Research Group, Khon Kaen University.,Department of Community Dentistry, Faculty of Dentistry, Khon Kaen University
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18
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Robertson RC, Manges AR, Finlay BB, Prendergast AJ. The Human Microbiome and Child Growth - First 1000 Days and Beyond. Trends Microbiol 2018; 27:131-147. [PMID: 30529020 DOI: 10.1016/j.tim.2018.09.008] [Citation(s) in RCA: 411] [Impact Index Per Article: 68.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/04/2018] [Accepted: 09/25/2018] [Indexed: 02/07/2023]
Abstract
The assembly of microbial communities within the gastrointestinal tract during early life plays a critical role in immune, endocrine, metabolic, and other host developmental pathways. Environmental insults during this period, such as food insecurity and infections, can disrupt this optimal microbial succession, which may contribute to lifelong and intergenerational deficits in growth and development. Here, we review the human microbiome in the first 1000 days - referring to the period from conception to 2 years of age - and using a developmental model, we examine the role of early microbial succession in growth and development. We propose that an 'undernourished' microbiome is intergenerational, thereby perpetuating growth impairments into successive generations. We also identify and discuss the intertwining host-microbe-environment interactions occurring prenatally and during early infancy, which may impair the trajectories of healthy growth and development, and explore their potential as novel microbial targets for intervention.
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Affiliation(s)
- Ruairi C Robertson
- Centre for Genomics & Child Health, Blizard Institute, Queen Mary University of London, UK.
| | - Amee R Manges
- University of British Columbia, School of Population and Public Health, Vancouver, BC, Canada; British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - B Brett Finlay
- Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada
| | - Andrew J Prendergast
- Centre for Genomics & Child Health, Blizard Institute, Queen Mary University of London, UK; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
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19
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Ananth CV, Andrews HF, Papapanou PN, Ward AM, Bruzelius E, Conicella ML, Albert DA. History of periodontal treatment and risk for intrauterine growth restriction (IUGR). BMC Oral Health 2018; 18:161. [PMID: 30268113 PMCID: PMC6162907 DOI: 10.1186/s12903-018-0623-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 09/16/2018] [Indexed: 11/10/2022] Open
Abstract
Background To explore the hypothesis that maternal periodontitis is associated with increased risk for Intrauterine Growth Restriction (IUGR), we examined the risk of IUGR in relation to periodontal treatment before, during and after pregnancy. Methods We conducted a retrospective cohort analysis of insurance claims data from 2009 to 2012 for women who delivered a singleton live birth (n = 32,168). IUGR was examined as a function of type and timing of dental treatment, adjusting for potential confounders in logistic regression. Sensitivity analysis evaluated the potential effects of unmeasured confounding. Results Women who received periodontal treatment after delivery, indicating the presence of untreated periodontal disease during pregnancy, had significantly higher odds of IUGR compared to women who received no periodontal treatment (adjusted OR 1.5, 95% CI 1.2, 1.8). Conclusions Periodontal treatment provided in the immediate postpartum period, a proxy for periodontitis during gestation, was associated with increased risk of IUGR. Electronic supplementary material The online version of this article (10.1186/s12903-018-0623-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cande V Ananth
- Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA.,Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Howard F Andrews
- Department of Biostatistics, Joseph L. Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.,New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, 10032, USA
| | - Angela M Ward
- Section of Population Oral Health, College of Dental Medicine, Columbia University, New York, NY, 10032, USA
| | - Emilie Bruzelius
- Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.,Section of Population Oral Health, College of Dental Medicine, Columbia University, New York, NY, 10032, USA
| | | | - David A Albert
- Section of Population Oral Health, College of Dental Medicine, Columbia University, New York, NY, 10032, USA.
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20
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Krüger MSDM, Casarin RP, Pinto GDS, Pappen FG, Camargo MBJ, Correa FOB, Romano AR. Maternal periodontal disease and adverse perinatal outcomes: is there an association? A hospital-based case-control study. J Matern Fetal Neonatal Med 2018; 32:3401-3407. [PMID: 29642740 DOI: 10.1080/14767058.2018.1464554] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objectives: The association between maternal periodontal disease and adverse perinatal outcomes although extensively studied remains unclear. The aim of this study was to evaluate, by a case-control study, conducted in three hospitals the association between preterm birth and/or low birth weight (PTB/LBW) and clinical parameters of maternal periodontal disease. Material and methods: Postpartum women who gave birth to a newborn PTB/LBW (case group), and postpartum women who had babies at full term with normal weight (control group) were included, in 1:2 ratio. Data were collected through medical records, interview, and periodontal clinical parameters. Bivariate analysis was performed to assess the PTB/LBW proportion relative to independent variables and multiple logistic regression analysis to assess the association between adverse perinatal outcomes and independent variables. Results: The sample consisted of 148 cases and 296 controls. By the 148 postpartum women with PTB/LBW in case group, 126 (87.5%) had preterm birth, and 75 (50.7%) had PTB and LBW. The periodontal status and generalized periodontitis presence were not associated with any adverse pregnancy outcomes. Having made four or more prenatal visits was a protective factor for all outcomes. The history of previous PTB/LBW was a risk factor for new cases of PTB and PTB and/or LBW. The presence of systemic disease was associated with preterm and low birth weight (PTLBW). Preeclampsia and cesarean delivery were associated with all outcomes. Conclusions: The clinical parameters of maternal periodontitis were not considered as a risk factor for the studied adverse perinatal outcomes. Clinical relevance: The present study demonstrated no association between maternal periodontitis and PTB/LBW.
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Affiliation(s)
| | | | | | | | | | | | - Ana Regina Romano
- a Graduate Program in Dentistry , Federal University of Pelotas , Pelotas , Brazil
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21
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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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22
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Govindasamy R, Dhanasekaran M, Varghese SS, Balaji VR, Karthikeyan B, Christopher A. Maternal Risk Factors and Periodontal Disease: A Cross-sectional Study among Postpartum Mothers in Tamil Nadu. J Pharm Bioallied Sci 2017; 9:S50-S54. [PMID: 29284936 PMCID: PMC5731044 DOI: 10.4103/jpbs.jpbs_88_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background and Aim It is inconclusive that periodontitis is an independent risk factor for adverse pregnancy outcomes. This study aims to investigate the association between maternal periodontitis and preterm and/or low birth weight babies. Settings and Design This was a prospective cross-sectional study. After prior informed consent, 3500 postpartum mothers were selected from various hospitals in Tamil Nadu and categorized into the following groups: group-1 - Normal term normal birth weight (n = 1100); Group-2 - Preterm normal birth weight (n = 400); Group-3 - preterm low birth weight (PTLBW) (n = 1000); and Group-4 - Normal term low birth weight (n = 1000). Periodontal examination was done, and risk factors were ascertained by means of questionnaire and medical records. Statistical Analysis Comparison between case groups and control groups were done, odds ratio (OR) was calculated, and statistical significance were assessed by Chi-square tests. To control for the possible confounders, all variables with P < 0.05 were selected and entered into multivariate regression model, and OR and 95% confidence limits were again estimated. SPSS-15 software was used. Results Periodontitis was diagnosed in 54.8%, 52.3%, 53.8%, 59.4%, respectively. On comparison between the groups, none of periodontal parameters showed significant association except for the crude association observed in Group-4 for mild periodontitis (OR - 1.561; P = 0.000) and PTLBW. Conclusion Periodontitis is not a significant independent risk factor, and obstetric factors contribute a major risk for preterm and/or low birth weight babies.
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Affiliation(s)
- Rohini Govindasamy
- Department of Periodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - Manikandan Dhanasekaran
- Department of Periodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - Sheeja S Varghese
- Department of Periodontics, Saveetha University, Chennai, Tamil Nadu, India
| | - V R Balaji
- Department of Periodontics, Saveetha University, Chennai, Tamil Nadu, India
| | - B Karthikeyan
- Department of Periodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - Ananthi Christopher
- Department of Pedodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
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Hirohata N, Komine-Aizawa S, Tamura M, Ochiai K, Sugitani M, Hayakawa S. Porphyromonas gingivalisSuppresses Trophoblast Invasion by Soluble Factors. J Periodontol 2017; 88:1366-1373. [DOI: 10.1902/jop.2017.170193] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Naoko Hirohata
- Department of Pathology and Microbiology, Division of Microbiology, Nihon University School of Medicine, Tokyo, Japan
- Department of Otolaryngology Head and Neck Surgery, Division of Oral Surgery, Nihon University School of Medicine
| | - Shihoko Komine-Aizawa
- Department of Pathology and Microbiology, Division of Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Muneaki Tamura
- Department of Microbiology, Nihon University School of Dentistry, Tokyo, Japan
| | - Kuniyasu Ochiai
- Department of Microbiology, Nihon University School of Dentistry, Tokyo, Japan
| | - Masahiko Sugitani
- Department of Pathology and Microbiology, Division of Pathology, Nihon University School of Medicine
| | - Satoshi Hayakawa
- Department of Pathology and Microbiology, Division of Microbiology, Nihon University School of Medicine, Tokyo, Japan
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Fogacci MF, Cardoso EDOC, Barbirato DDS, de Carvalho DP, Sansone C. No association between periodontitis and preterm low birth weight: a case-control study. Arch Gynecol Obstet 2017; 297:71-76. [PMID: 29022077 DOI: 10.1007/s00404-017-4556-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 09/28/2017] [Indexed: 12/16/2022]
Abstract
PURPOSE This study aimed to investigate the association between periodontitis in pregnant women and adverse pregnancy outcomes by heeding confounding risk factors for preterm low birth weight infants. METHODS This study was reported according to The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. A case-control study was conducted. Medical records of all pregnant women attending a prenatal care clinic were screened. Those between 21 and 34 years and gestational age of 28-32 weeks were initially enrolled in the study. The exclusion criteria were then applied: diabetes mellitus, genitourinary tract infections, or HIV infection; previous multiple gestations; previous preterm birth/low birth weight infants; in vitro fertilization procedures; placental, cervical/uterine abnormalities; history of infertility; history of drug abuse; and any medical conditions that required antibiotics prophylaxis. Patients' anthropometric, demographic, and behavioral characteristics were collected. The periodontal clinical parameters were obtained from six sites per tooth: clinical attachment level, probing pocket depth, dental plaque index, and gingival bleeding index. Women were then allocated into two groups: mothers of preterm and/or low birth weight newborns (cases) and mothers of full-term and normal birth weight newborns (controls). RESULTS Periodontal clinical parameters were analyzed and reported separately for each group, and no significant differences were observed (p > 0.05). Logistic regression analysis revealed that periodontal clinical parameters were not associated with the adverse pregnancy outcomes. CONCLUSION(S) After controlling for confounding factors, our results suggest that maternal periodontal disease is not a risk factor associated with preterm low birth weight infants.
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Affiliation(s)
- Mariana Fampa Fogacci
- Wolfgang C. Pfeiffer Laboratory of Environmental Biogeochemistry, Federal University of Rondônia (UNIR), BR 364, km 9, 5, Acre Direction, Porto Velho, Rondônia, CEP 76800-000, Brazil.
| | - Elaine de O C Cardoso
- Division of Graduate Periodontics, Department of Dental Clinic, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Davi da S Barbirato
- Wolfgang C. Pfeiffer Laboratory of Environmental Biogeochemistry, Federal University of Rondônia (UNIR), BR 364, km 9, 5, Acre Direction, Porto Velho, Rondônia, CEP 76800-000, Brazil
| | - Denise Pires de Carvalho
- Laboratory of Endocrine Physiology, Biophysics Institute Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carmelo Sansone
- Department of Dental Clinic, Division of Graduate Periodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Replication and refinement of a vaginal microbial signature of preterm birth in two racially distinct cohorts of US women. Proc Natl Acad Sci U S A 2017; 114:9966-9971. [PMID: 28847941 PMCID: PMC5604014 DOI: 10.1073/pnas.1705899114] [Citation(s) in RCA: 262] [Impact Index Per Article: 37.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Preterm birth (PTB) is the leading cause of neonatal morbidity and mortality. Previous studies have suggested that the maternal vaginal microbiota contributes to the pathophysiology of PTB, but conflicting results in recent years have raised doubts. We conducted a study of PTB compared with term birth in two cohorts of pregnant women: one predominantly Caucasian (n = 39) at low risk for PTB, the second predominantly African American and at high-risk (n = 96). We profiled the taxonomic composition of 2,179 vaginal swabs collected prospectively and weekly during gestation using 16S rRNA gene sequencing. Previously proposed associations between PTB and lower Lactobacillus and higher Gardnerella abundances replicated in the low-risk cohort, but not in the high-risk cohort. High-resolution bioinformatics enabled taxonomic assignment to the species and subspecies levels, revealing that Lactobacillus crispatus was associated with low risk of PTB in both cohorts, while Lactobacillus iners was not, and that a subspecies clade of Gardnerella vaginalis explained the genus association with PTB. Patterns of cooccurrence between L. crispatus and Gardnerella were highly exclusive, while Gardnerella and L. iners often coexisted at high frequencies. We argue that the vaginal microbiota is better represented by the quantitative frequencies of these key taxa than by classifying communities into five community state types. Our findings extend and corroborate the association between the vaginal microbiota and PTB, demonstrate the benefits of high-resolution statistical bioinformatics in clinical microbiome studies, and suggest that previous conflicting results may reflect the different risk profile of women of black race.
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Pereira PPDS, Da Mata FAF, Figueiredo ACG, de Andrade KRC, Pereira MG. Maternal Active Smoking During Pregnancy and Low Birth Weight in the Americas: A Systematic Review and Meta-analysis. Nicotine Tob Res 2017; 19:497-505. [PMID: 28403455 DOI: 10.1093/ntr/ntw228] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 09/16/2016] [Indexed: 12/15/2022]
Abstract
Introduction Smoking during pregnancy may negatively impact newborn birth weight. This study investigates the relationship between maternal active smoking during pregnancy and low birth weight in the Americas through systematic review and meta-analysis. Methods A literature search was conducted through indexed databases and the grey literature. Case-control and cohort studies published between 1984 and 2016 conducted within the Americas were included without restriction regarding publication language. The article selection process and data extraction were performed by two independent investigators. A meta-analysis of random effects was conducted, and possible causes of between-study heterogeneity were evaluated by meta-regressions and subgroup analyses. Publication bias was assessed by visual inspection of Begg's funnel plot and by Egger's regression test. Results The literature search yielded 848 articles from which 34 studies were selected for systematic review and 30 for meta-analysis. Active maternal smoking was associated with low birth weight, OR = 2.00 (95% CI: 1.77-2.26; I2 = 66.3%). The funnel plot and Egger's test (p = .14) indicated no publication bias. Meta-regression revealed that sample size, study quality, and the number of confounders in the original studies did not account for the between-study heterogeneity. Subgroup analysis indicated no significant differences when studies were compared by design, sample size, and regions of the Americas. Conclusion Low birth weight is associated with maternal active smoking during pregnancy regardless of the region in the Americas or the studies' methodological aspects. Implications A previous search of the major electronic databases revealed that no studies appear to have been conducted to summarize the association between maternal active smoking during pregnancy and low birth weight within the Americas. Therefore, this systematic review may help to fill the information gap. The region of the Americas contains some of the most populous countries in the world; therefore, this study may provide useful data from this massive segment of the world's population.
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Affiliation(s)
| | - Fabiana A F Da Mata
- Department of Medical Sciences, Faculty of Medicine, University of Brasilia, Brasilia, Brazil
| | | | | | - Maurício Gomes Pereira
- Department of Medical Sciences, Faculty of Medicine, University of Brasilia, Brasilia, Brazil
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Gokmen Karasu AF, Kutuk N, Aydin S, Adanir I, Ates S, Bademler N. Dental health dispositions of pregnant women: A survey from a hospital clinic in Istanbul. J OBSTET GYNAECOL 2017; 37:752-756. [PMID: 28467228 DOI: 10.1080/01443615.2017.1306837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Dental hygienic habits should be maintained in pregnancy despite challenges. We aimed to study the dental attitudes and habits of pregnant women. The patients attending our hospital clinic were invited to fill out a structured questionnaire categorised into three major domains: (1) general oral hygiene status, (2) dental habits, and (3) dental attandence both during pregnancy and prior to pregnancy. Four hundred and seventy four women agreed to participate. Mean age of participants was 28 (18-43). While 184 (38%) women reported brushing twice a day, only 98 (20%) women claimed using floss and or mouth rinse. Fifty-nine (12.4%) women had a dental visit in their current pregnancy and 24 (5.1%) received professional treatment. Obstetric care givers should convey the importance of dental care to their patients. We suggest that dental health should be improved antenatally, and be assessed in detail by dental health care providers. Impact Statement Poor oral health conditions have shown to be associated with an increased risk of adverse pregnancy outcomes, especially in low-income countries and regions. There is escalating evidence to support the lack of awareness among pregnant women about health consequences and long term risks associated with poor oral hygiene. Our results showed that dental hygienic practices of pregnant women are disconcerting in Turkey. The need for inter-professional collaboration among obstetric healthcare providers and dental specialistis is crucial for conveying to women the importance of dental care in pregnancy and beyond.
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Affiliation(s)
| | - Nukhet Kutuk
- b Department of Oral & Maxillofacial Surgery , Erciyes University , Melikgazi Kayseri , Turkey
| | - Serdar Aydin
- a Department of Obstetrics and Gynaecology , Bezmialem Vakif University , Istanbul , Turkey
| | - Ilknur Adanir
- a Department of Obstetrics and Gynaecology , Bezmialem Vakif University , Istanbul , Turkey
| | - Seda Ates
- a Department of Obstetrics and Gynaecology , Bezmialem Vakif University , Istanbul , Turkey
| | - Neslihan Bademler
- a Department of Obstetrics and Gynaecology , Bezmialem Vakif University , Istanbul , Turkey
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Abstract
This study assessed the strength of the association between socioeconomic status (SES) and low birth weight (LBW) and preterm birth (PTB) in Southwestern Ontario. Utilizing perinatal and neonatal databases at the London Health Science Centre, maternal postal codes were entered into a Geographic Information System to determine home neighbourhoods. Neighbourhoods were defined by dissemination areas (DAs). Median household income for each DA was extracted from the latest Canadian Census and linked to each mother. All singleton infants born between February 2009 and February 2014 were included. Of 26,654 live singleton births, 6.4% were LBW and 9.7% were PTB. Top risk factors for LBW were: maternal amphetamine use, chronic hypertension and maternal marijuana use (OR respectively: 17.51, 3.18, 2.72); previously diagnosed diabetes, maternal narcotic use and insulin-controlled gestational diabetes predicted PTB (OR respectively: 17.95, 2.69, 2.42). Overall, SES had little impact on adverse birth outcomes, although low maternal education increased the likelihood of a LBW neonate (OR: 1.01).
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Meqa K, Dragidella F, Disha M, Sllamniku-Dalipi Z. The Association between Periodontal Disease and Preterm Low Birthweight in Kosovo. Acta Stomatol Croat 2017; 51:33-40. [PMID: 28740268 PMCID: PMC5506254 DOI: 10.15644/asc51/1/4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 02/04/2017] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE Periodontal diseases have a high prevalence worldwide. Existing evidence support the concept that gingivitis and periodontitis are potentially infectious and they present inflammatory reservoirs that can be threatening to the fetoplacental unit. The objective of this study was to compare the periodontal status between women with normal delivery and those with preterm low-birthweight delivery. MATERIALS AND METHODS This study included 200 postpartum women whose periodontal and obstetrical parameters were taken. The periodontal condition was assessed bedside according to the modified criteria established by Machtei, while the birthweight and gestational age were assessed according to the World Health Organization criteria. RESULTS Women with periodontitis are statistically at 3.2 times higher risk to deliver a child with low weight, and at 3.4 times higher risk to deliver preterm, compared to women without periodontitis. The women with preterm low-birthweight babies had deeper periodontal pockets (2.49mm ± 0.49mm) than women with normal delivery (2.26mm ± 0.49mm). CONCLUSIONS Periodontal disease in pregnant women with a reservoir of organisms and their products can be considered a risk factor for adverse pregnancy outcome.
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Affiliation(s)
- Kastriot Meqa
- University of Pristina, Dentistry School, Department of Periodontology and Oral Medicine, Pristina, Republic of Kosovo
| | - Fatmir Dragidella
- University of Pristina, Dentistry School, Department of Periodontology and Oral Medicine, Pristina, Republic of Kosovo
| | - Metush Disha
- University of Pristina, Dentistry School, Department of Periodontology and Oral Medicine, Pristina, Republic of Kosovo
| | - Zana Sllamniku-Dalipi
- University of Pristina, Dentistry School, Department of Periodontology and Oral Medicine, Pristina, Republic of Kosovo
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A microbial perspective of human developmental biology. Nature 2016; 535:48-55. [PMID: 27383979 DOI: 10.1038/nature18845] [Citation(s) in RCA: 180] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 04/25/2016] [Indexed: 12/12/2022]
Abstract
When most people think of human development, they tend to consider only human cells and organs. Yet there is another facet that involves human-associated microbial communities. A microbial perspective of human development provides opportunities to refine our definitions of healthy prenatal and postnatal growth and to develop innovative strategies for disease prevention and treatment. Given the dramatic changes in lifestyles and disease patterns that are occurring with globalization, we issue a call for the establishment of 'human microbial observatories' designed to examine microbial community development in birth cohorts representing populations with diverse anthropological characteristics, including those undergoing rapid change.
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Ide M, Papapanou PN. Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes--systematic review. J Periodontol 2016; 84:S181-94. [PMID: 23631578 DOI: 10.1902/jop.2013.134009] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AND OBJECTIVES There is still debate regarding potential relationships between maternal periodontitis during pregnancy and adverse pregnancy outcomes. The aim of this systematic review was to synthesize the available epidemiological evidence on this association. DATA SOURCES Combined electronic and hand search of MEDLINE, EMBASE, WEB OF SCIENCE and Cochrane Central Register databases. STUDY ELIGIBILITY CRITERIA Original publications reporting data from cross-sectional, case-control or prospective cohort epidemiological studies on the association between periodontal status and preterm birth, low birthweight (LBW) or preeclampsia. The search was not limited to publications in English. All selected studies provided data based on professional assessments of periodontal status, and outcome variables, including preterm birth (<37 weeks gestation), LBW (<2500 g), gestational age, small for gestational age, birthweight, pregnancy loss or miscarriage, or pre-eclampsia. PARTICIPANTS Pregnant women with or without periodontal disease, and with or without adverse pregnancy outcomes, assessed either during pregnancy or postpartum. No intervention studies were included. Study appraisal and synthesis methods - Publications were assessed based on predefined screening criteria including type of periodontal assessment, consistency in the timing of the periodontal assessment with respect to gestational age, examiner masking and consideration of additional exposures and confounders. RESULTS Maternal periodontitis is modestly but significantly associated with LBW and preterm birth, but the use of a categorical or a continuous exposure definition of periodontitis appears to impact the findings: Although significant associations emerge from case-control and cross-sectional studies using periodontitis "case definitions," these were substantially attenuated in studies assessing periodontitis as a continuous variable. Data from prospective studies followed a similar pattern, but associations were generally weaker. Maternal periodontitis was significantly associated with pre-eclampsia. LIMITATIONS There is a high degree of variability in study populations, recruitment and assessment, as well as differences in how data are recorded and handled. As a result, studies included in meta-analyses show a high degree of heterogeneity. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Maternal periodontitis is modestly but independently associated with adverse pregnancy outcomes, but the findings are impacted by periodontitis case definitions. It is suggested that future studies employ both continuous and categorical assessments of periodontal status. Further use of the composite outcome preterm LBW is not encouraged.
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Affiliation(s)
- Mark Ide
- Periodontology, King's College London Dental Institute, London, UK.
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Temporal and spatial variation of the human microbiota during pregnancy. Proc Natl Acad Sci U S A 2015; 112:11060-5. [PMID: 26283357 DOI: 10.1073/pnas.1502875112] [Citation(s) in RCA: 734] [Impact Index Per Article: 81.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Despite the critical role of the human microbiota in health, our understanding of microbiota compositional dynamics during and after pregnancy is incomplete. We conducted a case-control study of 49 pregnant women, 15 of whom delivered preterm. From 40 of these women, we analyzed bacterial taxonomic composition of 3,767 specimens collected prospectively and weekly during gestation and monthly after delivery from the vagina, distal gut, saliva, and tooth/gum. Linear mixed-effects modeling, medoid-based clustering, and Markov chain modeling were used to analyze community temporal trends, community structure, and vaginal community state transitions. Microbiota community taxonomic composition and diversity remained remarkably stable at all four body sites during pregnancy (P > 0.05 for trends over time). Prevalence of a Lactobacillus-poor vaginal community state type (CST 4) was inversely correlated with gestational age at delivery (P = 0.0039). Risk for preterm birth was more pronounced for subjects with CST 4 accompanied by elevated Gardnerella or Ureaplasma abundances. This finding was validated with a set of 246 vaginal specimens from nine women (four of whom delivered preterm). Most women experienced a postdelivery disturbance in the vaginal community characterized by a decrease in Lactobacillus species and an increase in diverse anaerobes such as Peptoniphilus, Prevotella, and Anaerococcus species. This disturbance was unrelated to gestational age at delivery and persisted for up to 1 y. These findings have important implications for predicting premature labor, a major global health problem, and for understanding the potential impact of a persistent, altered postpartum microbiota on maternal health, including outcomes of pregnancies following short interpregnancy intervals.
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Souza LM, Cruz SSD, Gomes-Filho IS, Barreto ML, Passos-Soares JS, Trindade SC, Figueiredo ACMG, Alves CMC, Coelho JMF, Vianna MIP. Effect of maternal periodontitis and low birth weight--a case control study. Acta Odontol Scand 2015; 74:73-80. [PMID: 26018844 DOI: 10.3109/00016357.2015.1049374] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Since the 1990s, evidence has been raised that there is an association between maternal periodontal disease and undesirable gestational events, for example low birth weight; this issue is controversial. OBJECTIVE To evaluate whether there is an association between maternal periodontitis and low birth weight (LBW). METHODS A case-control study was carried out on 951 mothers that had been cared for by the Brazilian Unified Health System in Petrolina-PE and Juazeiro-BA, Brazil. The case group (n = 269) consisted of mothers of newborns with birth weight <2500 g and a control group (n = 682) of mothers of newborns with birth weight ≥2500 g. An interview was realized, using a questionnaire as well as a full mouth examination to diagnose the periodontal condition. Women who had at least four teeth with probing depth ≥4 mm and clinical attachment loss ≥3 mm, with bleeding on probing at the same site, were diagnosed with periodontitis. The birth weight was obtained through the hospital book record. The main association was evaluated using the multivariate regression model, considering confounders. RESULTS The frequency of periodontitis was 16.4% (case group) and 17.4% (control group). Periodontitis did not show an association with LBW (ORcrude = 0.92; 95% CI = 0.63-1.35), even after adjustment for the following confounders: maternal age, pre-gestational body mass index, number of pre-natal consultations, number of pregnancies, maternal schooling level, smoking habit during pregnancy and hypertension (ORadjusted = 1.00; 95% CI = 0.61-1.68). CONCLUSION The findings of this study showed no association between maternal periodontal disease and low birth weight, even after appropriate adjustments for confounding factors.
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Affiliation(s)
- Luise Maria Souza
- a 1 Department of Periodontics, Feira de Santana State University , Bahia, Brazil
| | - Simone Seixas da Cruz
- b 2 Health Sciences Center, Federal University of Recôncavo da Bahia, Santo Antônio de Jesus , Bahia, Brazil
| | | | - Mauricio Lima Barreto
- c 3 Collective Health Institute, Federal University of Bahia , Salvador, Bahia, Brazil
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Khairnar MS, Pawar BR, Marawar PP, Khairnar DM. Estimation of changes in C-reactive protein level and pregnancy outcome after nonsurgical supportive periodontal therapy in women affected with periodontitis in a rural set up of India. Contemp Clin Dent 2015; 6:S5-S11. [PMID: 25821375 PMCID: PMC4374319 DOI: 10.4103/0976-237x.152930] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Aims and Objectives: Estimation of changes in C-reactive protein (CRP) level and pregnancy outcome after nonsurgical supportive periodontal therapy in pregnant women affected with Periodontitis. Materials and Methods: A total of 100 pregnant females with periodontitis were assigned to treatment and control groups. All the details about previous and current pregnancies were obtained. Full-mouth periodontal examination was done at baseline, which included oral hygiene index simplified plaque index, gingival index, and clinical attachment loss. CRP level was also measured from collected blood sample initially at baseline and later after the delivery in both the group. Subjects in the treatment group received nonsurgical periodontal treatment during the second trimester of gestational period, and those in the control group did not receive any periodontal therapy during this period. Periodontal therapy included mechanical plaque control instructions and scaling and root planning. Outcome measures assessed were changes in CRP levels, gestational age, and birth weight of the infants. When delivery occurred at <37 weeks of gestation, it was considered as preterm birth (PTB), and low birth weight (LBW) was recorded when the infant weighed <2500 g. Results: In the treatment group, 32% of PTB and 68% of Normal term birth (NTB) delivery whereas in the control group 72% PTB and 28% of NTB were recorded. Infants measured with LBW were 36% in the treatment group and 52% in the control group. Mean birth weight was 2644.44 ± 450.53 g in the treatment group and 2447.82 ± 368.02 g in the control group (P < 0.05). Mean gestational age in the treatment group was 35.57 ± 2.40 weeks and 34.17 ± 2.92 weeks in the control group (P < 0.05). The treatment group showed statistically significant reduction in mean values of CRP level after delivery in comparison to baseline values (P < 0.05), whereas control group showed no significant reduction in values (P > 0.05). Conclusion: Nonsurgical supportive periodontal therapy may lower the risk of preterm delivery in females affected with periodontitis by reducing CRP level.
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Affiliation(s)
| | - Babita R Pawar
- Department of Periodontology, Rural Dental College, Pravara Institute of Medical Sciences University, Loni, Maharashtra, India
| | - Pramod P Marawar
- Department of Periodontology, Rural Dental College, Pravara Institute of Medical Sciences University, Loni, Maharashtra, India
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Walia M, Saini N. Relationship between periodontal diseases and preterm birth: Recent epidemiological and biological data. Int J Appl Basic Med Res 2015; 5:2-6. [PMID: 25664259 PMCID: PMC4318095 DOI: 10.4103/2229-516x.149217] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 06/27/2014] [Indexed: 11/10/2022] Open
Abstract
Preterm infants are born prior to completion of 37 weeks of gestation. These patients are seen on the rise despite the efforts put in to control them. Global incidence of preterm birth is around 9.6% of all birth representing 12.9 million births with regional disparities: From 12% to 13% in USA, from 5% to 9% in Europe, and 18% in Africa. First reported by Offenbacher et al. in 1996 relationship exist between maternal periodontal disease and delivery of a preterm infant. This article reviews the recent epidemiological and biological data. The articles were searched on Google, PubMed recent articles were selected. Mainly, three hypotheses by which periodontal bacteria can affect the outcome of pregnancy. Biological hypothesis: (a) Bacterial spreading, (b) Inflammatory products dissemination, (c) Role of fetomaternal immune response against oral pathogens. The promotion of the early detection and treatments of periodontal disease in young women before and during pregnancy will be beneficial especially for women at risk.
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Affiliation(s)
- Moneet Walia
- Department of Gynecology and Obstetrics, Christian Medical College, Ludhiana, Punjab, India
| | - Navdeep Saini
- Department of General Surgery, Christian Medical College, Ludhiana, Punjab, India
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Zi MYH, Longo PL, Bueno-Silva B, Mayer MPA. Mechanisms Involved in the Association between Periodontitis and Complications in Pregnancy. Front Public Health 2015; 2:290. [PMID: 25688342 PMCID: PMC4310218 DOI: 10.3389/fpubh.2014.00290] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 12/14/2014] [Indexed: 01/08/2023] Open
Abstract
The association between periodontitis and some of the problems with pregnancy such as premature delivery, low weight at birth, and preeclampsia (PE) has been suggested. Nevertheless, epidemiological data have shown contradictory data, mainly due to differences in clinical parameters of periodontitis assessment. Furthermore, differences in microbial composition and immune response between aggressive and chronic periodontitis are not addressed by these epidemiological studies. We aimed to review the current data on the association between some of these problems with pregnancy and periodontitis, and the mechanisms underlying this association. Shifts in the microbial composition of the subgingival biofilm may occur during pregnancy, leading to a potentially more hazardous microbial community. Pregnancy is characterized by physiological immune tolerance. However, the infection leads to a shift in maternal immune response to a pathogenic pro-inflammatory response, with production of inflammatory cytokines and toxic products. In women with periodontitis, the infected periodontal tissues may act as reservoirs of bacteria and their products that can disseminate to the fetus-placenta unit. In severe periodontitis patients, the infection agents and their products are able to activate inflammatory signaling pathways locally and in extra-oral sites, including the placenta-fetal unit, which may not only induce preterm labor but also lead to PE and restrict intrauterine growth. Despite these evidences, the effectiveness of periodontal treatment in preventing gestational complications was still not established since it may be influenced by several factors such as severity of disease, composition of microbial community, treatment strategy, and period of treatment throughout pregnancy. This lack of scientific evidence does not exclude the need to control infection and inflammation in periodontitis patients during pregnancy, and treatment protocols should be validated.
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Affiliation(s)
- Marcela Yang Hui Zi
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Priscila Larcher Longo
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Bruno Bueno-Silva
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Marcia Pinto Alves Mayer
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
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Jacob PS, Nath S. Periodontitis among poor rural Indian mothers increases the risk of low birth weight babies: a hospital-based case control study. J Periodontal Implant Sci 2014; 44:85-93. [PMID: 24778903 PMCID: PMC3999357 DOI: 10.5051/jpis.2014.44.2.85] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 02/28/2014] [Indexed: 11/16/2022] Open
Affiliation(s)
- Pulikottil Shaju Jacob
- Department of Clinical Dentistry, International Medical University School of Dentistry, Kuala Lumpur, Malaysia
| | - Sonia Nath
- Department of Periodontology, Vananchal Dental College and Hospital, Garhwa, India
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Faas MM, Kunnen A, Dekker DC, Harmsen HJM, Aarnoudse JG, Abbas F, De Vos P, Van Pampus MG. Porphyromonas Gingivalis and E-coli induce different cytokine production patterns in pregnant women. PLoS One 2014; 9:e86355. [PMID: 24466049 PMCID: PMC3899230 DOI: 10.1371/journal.pone.0086355] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 12/09/2013] [Indexed: 11/25/2022] Open
Abstract
Objective Pregnant individuals of many species, including humans, are more sensitive to various bacteria or their products as compared with non-pregnant individuals. Pregnant individuals also respond differently to different bacteria or their products. Therefore, in the present study, we evaluated whether the increased sensitivity of pregnant women to bacterial products and their heterogeneous response to different bacteria was associated with differences in whole blood cytokine production upon stimulation with bacteria or their products. Methods Blood samples were taken from healthy pregnant and age-matched non-pregnant women and ex vivo stimulated with bacteria or LPS from Porphyromonas Gingivalis (Pg) or E-coli for 24 hrs. TNFα, IL-1ß, IL-6, IL-12 and IL-10 were measured using a multiplex Luminex system. Results We observed a generally lower cytokine production after stimulation with Pg bacteria or it’s LPS as compared with E-coli bacteria. However, there was also an effect of pregnancy upon cytokine production: in pregnant women the production of IL-6 upon Pg stimulation was decreased as compared with non-pregnant women. After stimulation with E-coli, the production of IL-12 and TNFα was decreased in pregnant women as compared with non-pregnant women. Conclusion Our results showed that cytokine production upon bacterial stimulation of whole blood differed between pregnant and non-pregnant women, showing that the increased sensitivity of pregnant women may be due to differences in cytokine production. Moreover, pregnancy also affected whole blood cytokine production upon Pg or E-coli stimulation differently. Thus, the different responses of pregnant women to different bacteria or their products may result from variations in cytokine production.
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Affiliation(s)
- Marijke M. Faas
- Division of Medical Biology, Department of Pathology and Medical Biology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Alina Kunnen
- Department of Periodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
- School of Health Care Studies, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Daphne C. Dekker
- Division of Medical Biology, Department of Pathology and Medical Biology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Hermie J. M. Harmsen
- Department of Medical Microbiology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Jan G. Aarnoudse
- Department of Obstetrics and Gynecology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Frank Abbas
- Department of Periodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Paul De Vos
- Division of Medical Biology, Department of Pathology and Medical Biology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Maria G. Van Pampus
- Department of Obstetrics and Gynecology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
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Abstract
During pregnancy profound perturbations in innate and adaptive immunity impact the clinical course of a number of infectious diseases, including those affecting periodontal tissues. Conversely, it has been suggested that periodontal infections may increase the risk of adverse pregnancy outcomes. In this review, a summary of the literature associated with the bidirectional relationship between pregnancy and periodontal disease as well as the possible mechanisms behind this interaction were examined.
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Esteves Lima RP, Miranda Cota LO, Costa FO. Association Between Periodontitis and Gestational Diabetes Mellitus: A Case-Control Study. J Periodontol 2013; 84:1257-65. [DOI: 10.1902/jop.2012.120350] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ide M, Papapanou PN. Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes - systematic review. J Clin Periodontol 2013; 40 Suppl 14:S181-94. [DOI: 10.1111/jcpe.12063] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Mark Ide
- Periodontology; King's College London Dental Institute; London UK
| | - Panos N. Papapanou
- Section of Oral and Diagnostics Sciences; Division of Periodontics; Columbia University College of Dental Medicine; New York NY USA
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Shirakashi DJ, Leal RP, Colombo NH, Chiba FY, Garbin CA, Jardim EG, Antoniali C, Sumida DH. Maternal Periodontal Disease in Rats Decreases Insulin Sensitivity and Insulin Signaling in Adult Offspring. J Periodontol 2013; 84:407-14. [DOI: 10.1902/jop.2012.110372] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Guimarães AN, Silva-Mato A, Siqueira FM, Cyrino RM, Cota LOM, Costa FO. Very low and low birth weight associated with maternal periodontitis. J Clin Periodontol 2012; 39:1024-31. [PMID: 22994882 DOI: 10.1111/jcpe.12000] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2012] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to evaluate the association of very low and low birth weight (VLBW and LBW) with maternal periodontitis. MATERIAL AND METHODS Overall, 1206 women were examined at post-partum and two alternative criteria for periodontitis definition were used: (1) four or more teeth with at least one site with probing depth (PD) ≥ 4 mm and clinical attachment loss (CAL) ≥ 3 mm; and (2) at least one site with PD and CAL ≥ 4 mm. For each definition, two multivariate analyses were performed: (1) linear regression for birth weight; (2) ordinal logistic regression for birth weight, categorized as adequate (n = 1046), LBW (n = 145) and VLBW (n = 15). RESULTS Linear regression showed that maternal periodontitis was associated with a decrease in mean birth weight (periodontitis definition 1: p = 0.027; periodontitis definition 2: p = 0.003). Ordinal logistic regression showed that maternal periodontitis was associated with LBW and VLBW [odds ratio (OR) = 2.0; 95% confidence interval (CI) 1.39-2.90, when considering periodontitis definition 2]; and with LBW (OR = 1.65; 95% CI 1.15-2.36, when considering periodontitis definition 1). CONCLUSION Maternal periodontitis was associated with a decrease in mean birth weight, as well as with LBW and VLBW.
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Affiliation(s)
- Alessandra N Guimarães
- Department of Health and Socio-Medical Sciences, Biostatistics Unit, Faculty of Medicine, Alcalá University, Madrid, Spain
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Corbella S, Del Fabbro M, Taschieri S, Francetti L. Periodontal disease and adverse pregnancy outcomes: a systematic review. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.ios.2011.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Michelin MCAN, Teixeira SRL, Ando-Suguimoto ES, Lucas SRR, Mayer MPA. Porphyromonas gingivalis infection at different gestation periods on fetus development and cytokines profile. Oral Dis 2012; 18:648-54. [PMID: 22471815 DOI: 10.1111/j.1601-0825.2012.01917.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AIM Infective agents may affect pregnancy outcomes by deregulating homeostasis. OBJECTIVES The effects of Porphyromonas gingivalis infection before and at different gestation periods were evaluated. MATERIALS AND METHODS Wistar rats infected via subcutaneous with P. gingivalis W83, one week before mating (BM), days 1 (PR1) and 11 of gestation (PR11), and controls were evaluated, and samples were obtained at the end of gestation. P. gingivalis was detected by PCR. Cytokine was determined by ELISA. RESULTS Infected rats had lower maternal gain of weight. Implantation was not observed in 2/12 BM rats. PR11 presented more fetal-placental resorptions and lower placenta/fetus weight than controls. P. gingivalis was detected in placenta and fetus. IL-6 and TNF-α levels were higher in placenta and serum of infected groups, except for TNF-α in placenta of PR1. IL-1β levels were higher in placenta of PR11, but lower in serum and placenta of PR1. There were no differences in IL-10 and PGE2 concentrations among the groups (P < 0.05). CONCLUSIONS The experimental infection by P. gingivalis resulted in alterations in the gestational pattern and in fetal development. The consequences of infection at mid-gestation were more severe than at the beginning, possibly due to the induction of pro-inflammatory cytokines in the fetal compartment.
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Affiliation(s)
- M C A N Michelin
- Department of Morphology and Genetics, Laboratory of Developmental Biology, Federal University of Sao Paulo, Sao Paulo, Brazil
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Mannem S, Chava VK. The relationship between maternal periodontitis and preterm low birth weight: A case-control study. Contemp Clin Dent 2011; 2:88-93. [PMID: 21957382 PMCID: PMC3180843 DOI: 10.4103/0976-237x.83067] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The relationship between periodontal diseases in pregnancy and children born prematurely or with low birth weight has been increasingly investigated, showing positive and negative results, respectively. Objective: To evaluate the association between Maternal Periodontitis and Preterm delivery or Low Birth Weight. Materials and Methods: In this case-control study, 104 pregnant women without systemic disease or other risk factors for preterm labor were chosen. The control group (n = 52) had term labor (infants ≥37 weeks) and the case group (n = 52) had preterm labor (infants <37 weeks). Plaque index, bleeding index, and birth weight were measured. Results: The data of plaque index (cases 1.21±0.56; controls 0.63±0.31), bleeding index (cases, 2.08±0.62; controls, 1.52±0.61), birth weight (cases, 2.01±0.36; controls 2.87±0.32), and Probing Pocket Depth (PPD) ≥4mm and Clinical Attachment Level (CAL) ≥3mm in at least 4 teeth (odds ratio 137.50, P value < 0.0001) revealed a statistically significant difference between the two groups P< 0.05). Conclusions: A noticeable relationship between periodontal health and duration of pregnancy; periodontal disease could be a risk factor for preterm labor. Oral hygiene maintenance should be a part of prenatal care protocol.
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Affiliation(s)
- Satheesh Mannem
- Department of Periodontics, Vishnu Dental College, Bhimavarm, West Godavari District, Andhra Pradesh, India
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Wallace NT, Carlson MJ, Mosen DM, Snyder JJ, Wright BJ. The individual and program impacts of eliminating Medicaid dental benefits in the Oregon Health Plan. Am J Public Health 2011; 101:2144-50. [PMID: 21680938 PMCID: PMC3222412 DOI: 10.2105/ajph.2010.300031] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2010] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We determined how elimination of dental benefits among adult Medicaid beneficiaries in Oregon affected their access to dental care, Medicaid expenditures, and use of medical settings for dental services. METHODS We used a natural experimental design using Medicaid claims data (n = 22 833) before and after Medicaid dental benefits were eliminated in Oregon in 2003 and survey data for continuously enrolled Oregon Health Plan enrollees (n = 718) covering 3 years after benefit cuts. RESULTS Claims analysis showed that, compared with enrollees who retained dental benefits, those who lost benefits had large increases in dental-related emergency department use (101.7%; P < .001) and expenditures (98.8%; P < .001) and in all ambulatory medical care use (77.0%; P < .01) and expenditures (114.5%; P < .01). Survey results indicated that enrollees who lost dental benefits had nearly 3 times the odds (odds ratio = 2.863; P = .001) of unmet dental need, and only one third the odds (odds ratio = 0.340; P = .001) of getting annual dental checkups relative to those retaining benefits. CONCLUSIONS Combined evidence from both analyses suggested that the elimination of dental benefits resulted in significant unmet dental health care needs, which led to increased use of medical settings for dental problems.
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Affiliation(s)
- Neal T Wallace
- Portland State University, Portland, OR 97207-0751, USA.
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Relationship between periodontal diseases and preterm birth: recent epidemiological and biological data. J Pregnancy 2011; 2011:164654. [PMID: 22132334 PMCID: PMC3205685 DOI: 10.1155/2011/164654] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 10/03/2011] [Indexed: 01/02/2023] Open
Abstract
For ten years, the incidence of preterm birth does not decrease in developed countries despite the promotion of public health programs. Many risk factors have been identified including ethnicity, age, tobacco, and infection. However, almost 50% of preterm birth causes remain unknown. The periodontal diseases are highly prevalent inflammatory and infectious diseases of tooth supporting tissues leading to an oral disability. They influence negatively general health worsening cardiovascular diseases and diabetes. Periodontal diseases have been also suspected to increase the rate of preterm birth, but data remain contradictory. The objective of this review is to present the principal results of epidemiological, biological, and interventional studies on the link between periodontal diseases and preterm birth. The conclusions of this work underline the importance for the physician/obstetrician to identify women at risk for preterm birth and to address these patients to dentist for periodontal examination and treatment in order to limit adverse pregnancy outcomes.
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Sant'Ana ACP, Campos MRD, Passanezi SC, Rezende MLRD, Greghi SLA, Passanezi E. Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial. J Appl Oral Sci 2011; 19:130-6. [PMID: 21552714 PMCID: PMC4243751 DOI: 10.1590/s1678-77572011000200009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2009] [Accepted: 02/21/2010] [Indexed: 11/22/2022] Open
Abstract
Objectives The aim of this study was to evaluate the effects of non-surgical treatment of
periodontal disease during the second trimester of gestation on adverse pregnancy
outcomes. Material and Methods Pregnant patients during the 1st and 2nd trimesters at
antenatal care in a Public Health Center were divided into 2 groups: NIG – "no
intervention" (n=17) or IG- "intervention" (n=16). IG patients were submitted to a
non-surgical periodontal treatment performed by a single periodontist consisting
of scaling and root planning (SRP), professional prophylaxis (PROPH) and oral
hygiene instruction (OHI). NIG received PROPH and OHI during pregnancy and were
referred for treatment after delivery. Periodontal evaluation was performed by a
single trained examiner, blinded to periodontal treatment, according to probing
depth (PD), clinical attachment level (CAL), plaque index (PI) and sulcular
bleeding index (SBI) at baseline and 35 gestational weeks-28 days
post-partum. Primary adverse pregnancy outcomes were preterm
birth (<37 weeks), low birth weight (<2.5 kg), late abortion (14-24 weeks)
or abortion (<14 weeks). The results obtained were statistically evaluated
according to OR, unpaired t test and paired t test at 5% significance level. Results No significant differences were observed between groups at baseline examination.
Periodontal treatment resulted in stabilization of CAL and PI (p>0.05) at IG
and worsening of all periodontal parameters at NIG (p<0.0001), except for PI.
Significant differences in periodontal conditions of IG and NIG were observed at
2nd examination (p<0.001). The rate of adverse pregnancy
outcomes was 47.05% in NIG and 6.25% in IG. Periodontal treatment during pregnancy
was associated to a decreased risk of developing adverse pregnancy outcomes
[OR=13.50; CI: 1.47-123.45; p=0.02]. Conclusions Periodontal treatment during the second trimester of gestation contributes to
decrease adverse pregnancy outcomes.
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