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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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Gallagher-Cobos G, Almerich-Torres T, Montiel-Company JM, Iranzo-Cortés JE, Bellot-Arcís C, Ortolá-Siscar JC, Almerich-Silla JM. Relationship between Periodontal Condition of the Pregnant Woman with Preterm Birth and Low Birth Weight. J Clin Med 2022; 11:6857. [PMID: 36431334 PMCID: PMC9694647 DOI: 10.3390/jcm11226857] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/11/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to determine the association between the mother’s periodontal condition and perinatal complications, such as preterm birth (PTB) and/or low birth weight (LBW), in a cohort of women in Valencia, Spain. Other related factors, such as tobacco, were also analysed. A prospective cohort study was carried out in a sample of 102 women with a single foetus and ages ranging between 18 and 42 years. Sociodemographic and obstetric variables, caries status, percentage of bleeding, clinical attachment loss (CAL), and probing pocket depth (PPD) data have been collected and analysed. The mean age was 32.4 years, and the BMI was normal. The average weight of new-borns (NB) was 3034 g. A total of 9.8% of the women smoked during their pregnancy. Bleeding percentage was 16.43% (SD 14.81%) and PPDs > 3 mm 8.8 (SD 11.08). The mean of CAL > 0 mm was 1.14 (SD 2.83). The frequency of PTB and LBW was 26%. No statistically significant differences were found between probing depth > 3 mm or CAL > 1 mm, with PTB and/or LBW. Periodontal disease in the mother was not statistically significantly related to either PTB or LBW. Tobacco use during pregnancy showed a statistical significance linked to LBW, but not with PTB.
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Micu IC, Roman A, Ticala F, Soanca A, Ciurea A, Objelean A, Iancu M, Muresan D, Caracostea GV. Relationship between preterm birth and post-partum periodontal maternal status: a hospital-based Romanian study. Arch Gynecol Obstet 2020; 301:1189-1198. [PMID: 32274638 DOI: 10.1007/s00404-020-05521-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 03/28/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE This cross-sectional case-control study of post-partum women aimed to estimate whether maternal periodontitis was a predictive contributor to preterm birth and to identify other risk factors associated with preterm birth in our target population. METHODS The case group included women who delivered preterm (74 cases) and the control group included women who had a normal term delivery (120 controls). Medical records, a 16-item questionnaire, and a full-mouth periodontal examination were used to collect information about socio-demographic characteristics, general health problems, birth-related information, behavioral factors and periodontal status. Logistic regression analysis was used to estimate the strength of the relationship between predictors and the categorical outcome variable, preterm birth. RESULTS The bivariate analysis revealed the significant associations between preterm birth and socio-demographic factors (educational level, p = 0.003), antepartum smoking habit (p = 0.001) and birth weight lower than 2500 g (p < 0.001). The multivariate analysis highlighted that the presence of post-partum maternal periodontitis and its severity remained independent risk factors of preterm birth in the presence of antepartum smoking habit and route of delivery [adjusted OR 2.26, 95% CI (1.06; 4.82), respectively, OR 3.46, 95% CI (1.08; 11.15)]. CONCLUSION Post-partum maternal periodontal disease and its severity might, in part, be considered as contributor to preterm deliveries before 37 weeks of gestation.
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Affiliation(s)
- I C Micu
- Department of Periodontology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 15 V. Babeş St., 400012, Cluj-Napoca, Romania
| | - A Roman
- Department of Periodontology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 15 V. Babeş St., 400012, Cluj-Napoca, Romania.,Emegency County Clinical Hospital, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania
| | - F Ticala
- Department of Obstetrics and Gynecology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 3-5 Clinicilor St, 400006, Cluj-Napoca, Romania
| | - A Soanca
- Department of Periodontology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 15 V. Babeş St., 400012, Cluj-Napoca, Romania.,Emegency County Clinical Hospital, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania
| | - A Ciurea
- Department of Periodontology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 15 V. Babeş St., 400012, Cluj-Napoca, Romania
| | - A Objelean
- Department of Dental Materials, "Iuliu Haţieganu" University of Medicine and Pharmacy, 15 V. Babeş St., 400012, Cluj-Napoca, Romania
| | - M Iancu
- Department of Medical Informatics and Biostatistics, "Iuliu Haţieganu" University of Medicine and Pharmacy, 6 Louis Pasteur St., 400349, Cluj-Napoca, Romania.
| | - D Muresan
- Department of Obstetrics and Gynecology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 3-5 Clinicilor St, 400006, Cluj-Napoca, Romania.,Emegency County Clinical Hospital, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania
| | - G V Caracostea
- Department of Obstetrics and Gynecology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 3-5 Clinicilor St, 400006, Cluj-Napoca, Romania.,Emegency County Clinical Hospital, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania
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Khadija B, Abbasi A, Khan S, Nadeem M, Badshah L, Faryal R. Isolation of pathogenic Candida species from oral cavity of postpartum females, and its association with obstetric and dental problems. Microb Pathog 2019; 131:40-46. [PMID: 30905714 DOI: 10.1016/j.micpath.2019.03.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 01/31/2019] [Accepted: 03/18/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of the current study was to investigate pathogenic Candida spp. Colonization in oral cavity of postpartum females and its association with adverse pregnancy outcomes (APOs) and dental issues. METHODS Saliva samples and clinico-demographic data were collected from 267 postpartum females along with 54 non-pregnant females (Jan 2016-March 2018). Isolation of Candida was carried out by using standard microbiological methods and different virulence factors (Esterase activity, phospholipase activity and biofilm formation) were evaluated. RESULTS Candidacolonization was high in postpartum females (p<0.001, OR = 4.28). This colonization was not significant among females with APOs, however, one to three folds risk was seen with different obstetric and dental factors. High esterase activity was seen among Candida isolates from postpartum females in comparison to control group (p = 0.01). Phospholipase activity of C.albicans isolates from this group was also high (p = 0.001). Majority of the Candida isolates (66.87%) from postpartum females were biofilm formers. Increase in antifungal activity was seen among isolates from postpartum females, with 85% isolates resistant to Fluconazole and Voriconazole (p<0.001) and Amphotericin B resistance was present in 64.38% isolates (p<0.001). CONCLUSION Postpartum females are more susceptible to oral Candida colonization, which exhibit enhanced virulence characteristics and its carriage are associated with increased risk for development of APOs and dental problems.
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Affiliation(s)
- Bibi Khadija
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Aqsa Abbasi
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Sadia Khan
- Holy Family Hospital, Rawalpindi Medical College, Rawalpindi, Pakistan
| | - Meera Nadeem
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Lal Badshah
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Rani Faryal
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan.
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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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Blanc V, O'Valle F, Pozo E, Puertas A, León R, Mesa F. Oral bacteria in placental tissues: increased molecular detection in pregnant periodontitis patients. Oral Dis 2015; 21:905-12. [PMID: 26259070 DOI: 10.1111/odi.12364] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/23/2015] [Accepted: 07/30/2015] [Indexed: 01/31/2023]
Abstract
OBJECTIVES The objective of this study was to identify the DNA of oral bacteria in placental samples from women with and without periodontitis who had or had not had preterm births and/or low birthweight (PB/LBW) neonates. METHODS Data were gathered from 57 puerperal women in relation to socio-demographic, gynaecological, and periodontal variables and to placental histomorphology. Fifty-seven biopsies, 28 from mothers with periodontitis, were taken aseptically from preterm placentas (n = 36) and from full-term placentas (n = 21). Total DNA was extracted, and the presence of 15 oral bacteria was assessed using Nested-PCR. RESULTS The placentas from women with periodontitis showed a higher prevalence of periodontopathogens compared to those from women without periodontitis (P = 0.009). Samples showed low prevalences of Actinomyces israelii, Parvimonas micra and Tannerella forsythia. An association was found between Eikenella corrodens in placenta and periodontitis (P = 0.002). The most ubiquitous bacterium, Fusobacterium nucleatum, was more prevalent in mothers with periodontitis and PB/LBW (P = 0.033). Porphyromonas gingivalis, Treponema denticola, Prevotella intermedia and Aggregatibacter actinomycetemcomitans were not detected. CONCLUSIONS These results, along with previous findings, show that oral bacteria may be normally present in the placenta, however, the levels of certain oral pathogens in the placenta would highly depend on the mother's periodontal state.
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Affiliation(s)
- V Blanc
- Microbiology Laboratory, Dentaid Research Center, Cerdanyola del Valles, Barcelona, Spain
| | - F O'Valle
- Pathology Department, School of Medicine, University of Granada, Granada, Spain
| | - E Pozo
- Periodontology Department, School of Dentistry, University of Granada, Granada, Spain
| | - A Puertas
- Department of Obstetrics and Gynaecology, Virgen de las Nieves University Hospital, Granada, Spain
| | - R León
- Microbiology Laboratory, Dentaid Research Center, Cerdanyola del Valles, Barcelona, Spain
| | - F Mesa
- Periodontology Department, School of Dentistry, University of Granada, Granada, Spain
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