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El Hassan NK, Ramadan AM. Interleukin 1 beta and its association with the periodontal health of pregnant women. J Taibah Univ Med Sci 2023; 18:1376-1383. [PMID: 37332485 PMCID: PMC10275976 DOI: 10.1016/j.jtumed.2023.05.012] [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: 02/16/2023] [Revised: 04/18/2023] [Accepted: 05/12/2023] [Indexed: 06/20/2023] Open
Abstract
Objectives In this study, we measured and compared serum and gingival crevicular fluid (GCF) levels of interleukin 1 beta (IL-1β) in pregnant women with periodontitis and pregnant women with a healthy periodontium. We also determined the prevalence of periodontitis among pregnant women attending Omdurman Midwifery Hospital. Materials This was a hospital-based clinical study and laboratory investigation using ELISA tests of 80 pregnant women in the third trimester conducted at the Omdurman Midwifery Hospital in Khartoum, Sudan. The study group consisted of 50 women while the control group consisted of 30 women. Results Independent samples t-tests were used to compare serum and GCF levels of IL-1β between the study and control groups. Pearson's correlation analysis was also used to compare gingival parameters and IL-1β levels in the GCF. For each comparison, the p-value was fixed at 0.05. The GCF in the research group showed a considerable increase in IL-1β levels. There was also a strong positive association between high IL-1β levels in the research group's GCF and probing pocket depth (PPD) and clinical attachment level (CAL) levels. Conclusions Our study provides further evidence that periodontitis, as measured by a PD ≥4 mm and a CAL ≥3 mm, is associated with an increased level of IL-1β in the GCF of pregnant women with active periodontal disease during pregnancy and may include the transient translocation of oral organisms to the utero-placental unit, inciting placental inflammation or oxidative stress early in pregnancy, ultimately resulting in placental damage and clinical manifestations.
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Affiliation(s)
- Nawal K.B. El Hassan
- Department of Periodontics, Faculty of Dental Medicine and Surgery, El Razi University, Khartoum, Sudan
| | - AbdelRahman M. Ramadan
- Department of Oral and Basic Clinical Sceinces, Ibn Sina National College for Medical Sciences, Jeddah, KSA
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2
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Butera A, Maiorani C, Morandini A, Simonini M, Colnaghi A, Morittu S, Barbieri S, Ricci M, Guerrisi G, Piloni D, Cimarossa R, Fusaro B, Sinesi A, Bruni A, Scribante A. Assessment of Oral Microbiome Changes in Healthy and COVID-19-Affected Pregnant Women: A Narrative Review. Microorganisms 2021; 9:2385. [PMID: 34835510 PMCID: PMC8618476 DOI: 10.3390/microorganisms9112385] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022] Open
Abstract
During pregnancy, there are several metabolic changes and an alteration in the composition of microorganisms that inhabit the oral cavity, with an increase in pathogenic bacteria that promote the onset of gingival diseases. This review is based on research in reference to the PICO model (Problem/Intervention/Comparison/Outcome), related to changes in the oral microbiome of pregnant women and possible oral consequences in patients with COVID-19. The results showed a growth of some pathogenic bacteria in pregnant women, including Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum, and the selective growth of the Prevotella intermedia, Porphyromonas gingivalis and Tannerella species, probably due to the fact that these bacteria use progesterone as a source of nutrition. These same bacteria are implicated in the development of periodontal disease. Periodontal pockets have bidirectional interactions between the oral cavity and the systemic circulatory system through the peripheral gingival blood vessels. The affinity of the SARS-CoV-2 virus to specific membrane receptors is now clear, and could involve the internal and external epithelial lining or the fibroblasts of the periodontal ligament. According to the results of the present review, the control of oral microbiome changes during pregnancy would be welcomed. The use of probiotics could help clinicians manage pregnant patients, reducing inflammatory indexes. Future studies should focus not only on changes in the level of the oral microbiome in pregnancy or the correlation between periodontal disease and COVID-19, but also on oral changes induced by both clinical situations.
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Affiliation(s)
- Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Carolina Maiorani
- Member Association: “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (A.C.); (S.M.); (S.B.); (M.R.); (G.G.); (D.P.); (R.C.); (B.F.); (A.S.); (A.B.)
| | - Annalaura Morandini
- Member Association: “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (A.C.); (S.M.); (S.B.); (M.R.); (G.G.); (D.P.); (R.C.); (B.F.); (A.S.); (A.B.)
| | - Manuela Simonini
- Member Association: “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (A.C.); (S.M.); (S.B.); (M.R.); (G.G.); (D.P.); (R.C.); (B.F.); (A.S.); (A.B.)
| | - Arianna Colnaghi
- Member Association: “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (A.C.); (S.M.); (S.B.); (M.R.); (G.G.); (D.P.); (R.C.); (B.F.); (A.S.); (A.B.)
| | - Stefania Morittu
- Member Association: “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (A.C.); (S.M.); (S.B.); (M.R.); (G.G.); (D.P.); (R.C.); (B.F.); (A.S.); (A.B.)
| | - Stefania Barbieri
- Member Association: “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (A.C.); (S.M.); (S.B.); (M.R.); (G.G.); (D.P.); (R.C.); (B.F.); (A.S.); (A.B.)
| | - Maria Ricci
- Member Association: “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (A.C.); (S.M.); (S.B.); (M.R.); (G.G.); (D.P.); (R.C.); (B.F.); (A.S.); (A.B.)
| | - Gaetano Guerrisi
- Member Association: “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (A.C.); (S.M.); (S.B.); (M.R.); (G.G.); (D.P.); (R.C.); (B.F.); (A.S.); (A.B.)
| | - Daniela Piloni
- Member Association: “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (A.C.); (S.M.); (S.B.); (M.R.); (G.G.); (D.P.); (R.C.); (B.F.); (A.S.); (A.B.)
| | - Roberta Cimarossa
- Member Association: “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (A.C.); (S.M.); (S.B.); (M.R.); (G.G.); (D.P.); (R.C.); (B.F.); (A.S.); (A.B.)
| | - Barbara Fusaro
- Member Association: “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (A.C.); (S.M.); (S.B.); (M.R.); (G.G.); (D.P.); (R.C.); (B.F.); (A.S.); (A.B.)
| | - Antonia Sinesi
- Member Association: “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (A.C.); (S.M.); (S.B.); (M.R.); (G.G.); (D.P.); (R.C.); (B.F.); (A.S.); (A.B.)
| | - Ambra Bruni
- Member Association: “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (A.C.); (S.M.); (S.B.); (M.R.); (G.G.); (D.P.); (R.C.); (B.F.); (A.S.); (A.B.)
| | - Andrea Scribante
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
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3
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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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Wang H, Ma L, Pan X, Du Z, Chen Y. Novel associations of SNPs MYLIP rs3757354 and ABCA1 2230806 gene with early-onset-preeclampsia: A case-control candidate genetic study. Pregnancy Hypertens 2021; 23:185-190. [PMID: 33450693 DOI: 10.1016/j.preghy.2020.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate the association between MYLIP rs3757354 and ABCA1 2230806 single nucleotide polymorphisms in women with preeclampsia in China. STUDY DESIGN The case-control study involved 205 patients with preeclampsia and 145 controls. All women with preeclampsia were divided into two groups: 78 patients with early-onset preeclampsia and 127 with late-onset preeclampsia. MAIN OUTCOME MEASURE MYLIP rs3757354 and ABCA1 rs2230806 SNPs were analyzed through multiplex PCR for targeted next-generation sequencing technology. A secondary outcome was lipid profile changes and liver function in women with PE. RESULTS Maternal age (OR: 1.073, 95% CI = 1.006-1.145), BMI (OR: 1.118, 95% CI = 1.040-1.201), TG/HDL-C (OR: 1.536, 95% CI = 1.080-2.183), and TT genotype of SNP rs3757354 (OR: 3.238, 95% CI = 1.313-7.990) were associated with EOPE risk. Our study found that patients with TT genotype of ABCA1 rs2230806 had more severe hepatic dysfunction and higher HDL levels in the EOPE group compared with CC/CT genotype. There was no association between rs2230806 and the risk of PE. CONCLUSION The polymorphisms of rs3757354 are associated with the risk of EOPE in Chinese pregnant women. The TT genotype in ABCA1 rs2230806 is a strong predictive risk for elevated aminotransferase levels in pregnant women with EOPE.
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Affiliation(s)
- He Wang
- The First Hospital of Jilin University, Department of Obstetrics, Changchun, Jilin Province 130021, China
| | - Lingyu Ma
- The First Hospital of Jilin University, Department of Obstetrics, Changchun, Jilin Province 130021, China
| | - Xuefeng Pan
- The First Hospital of Jilin University, Department of Obstetrics, Changchun, Jilin Province 130021, China
| | - Zhaoli Du
- Institute of Genetic Technology, Yinfeng Bilogical Group, Yinfeng Gene Technology Company Limited, Jinan, Shandong Province 250014, China
| | - Ying Chen
- The First Hospital of Jilin University, Department of Obstetrics, Changchun, Jilin Province 130021, China.
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5
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Heo JS, Ahn KH, Park JS. Radiological screening of maternal periodontitis for predicting adverse pregnancy and neonatal outcomes. Sci Rep 2020; 10:21266. [PMID: 33277556 PMCID: PMC7718227 DOI: 10.1038/s41598-020-78385-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/24/2020] [Indexed: 12/04/2022] Open
Abstract
It is well known that periodontitis, diagnosed mainly by periodontal probing, is associated with adverse pregnancy outcomes. However, periodontal probing is time-consuming, highly discomforting, inaccurate, and invasive. We aimed to assess whether periodontitis severity based on radiological staging in accordance with the 2017 new consensus classification was related to adverse pregnancy and neonatal outcomes. The medical records of 165 mothers who underwent panoramic radiography within 5 years before and after the time of delivery and of their singleton neonates were retrospectively reviewed. Twenty-two mothers (13.3%) had severe periodontitis (SP), and 143 (86.7%) had mild or moderate periodontitis (MP). In relation to adverse pregnancy outcomes, uterine leiomyoma (18.2% vs. 4.2%, P = 0.029), chronic hypertension (9.1% vs. 0.7%, P = 0.047), and preeclampsia (13.6% vs. 2.1%, P = 0.032) occurred significantly more frequently in the SP group than in the MP group. The incidences of very preterm birth (13.6% vs. 1.4%, P = 0.017), extremely preterm birth (9.1% vs. 0.7%, P = 0.047), and small for gestational age (22.7% vs. 5.6%, P = 0.017) were also significantly higher in the SP group than in the MP group. Radiological screening of maternal periodontitis could be useful for predicting adverse pregnancy and neonatal outcomes as well as diagnosing SP in pregnant women.
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Affiliation(s)
- Ju Sun Heo
- Department of Pediatrics, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ki Hoon Ahn
- Department of Obstetrics and Gynecology, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
| | - Jung Soo Park
- Department of Periodontology, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
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6
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Conceição SDS, Gomes-Filho IS, Coelho JMF, Brito SM, Silva RB, Batista JET, Figueiredo ACMG, Hintz AM, Lyrio AO, Souza ES, Pereira MG, Loomer PM, Cruz SSD. An accuracy study of the clinical diagnosis of periodontitis in pregnant women. J Periodontol 2020; 92:1243-1251. [PMID: 33252149 DOI: 10.1002/jper.20-0441] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND There exists a diverse range of criteria used in epidemiological studies for the diagnosis of periodontitis. The results from these studies should be evaluated with consideration to the diagnostic criteria used, and this may account for differences between studies especially in some population groups such as pregnant females. The objective is to evaluate the diagnostic criteria used in a variety of epidemiologic studies of periodontitis in pregnant females. METHODS An accuracy study with cross-sectional design was performed out from a database of 671 pregnant females, using six different sets of criteria for the diagnosis of periodontitis. Women were classified for periodontitis, as follows: Center for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP, 2012 criterion), the gold standard, Gomes-Filho et al.(2018) criterion, Albandar et al.(2007) criterion, Bassani et al.(2007) criterion, López et al.(2002) criterion, and Nesse et al.(2008) criterion. For comparison amongst the gold standard and the other criteria, sensitivity, specificity, predictive values, and likelihood ratio were determined. RESULTS The frequency of periodontitis ranged from 25.0% to 90.2%. The Bassani et al. (2007) criterion was found to be more sensitive among the studies, and thus more suitable for diagnostic screening studies. Gomes-Filho et al.(2018), Albandar et al. (2007), López et al. (2002), and Nesse et al. (2008) criteria were considered more specific, which makes them more useful for studies of periodontitis with the aim of using diagnosis for confirmation of disease. CONCLUSIONS A variation in the occurrence of periodontitis was observed. The criterion must be chosen according to the research aims and population characteristics.
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Affiliation(s)
| | | | | | - Sheila Monteiro Brito
- Health Sciences Center, Federal University of Recôncavo of Bahia, Santo Antônio de Jesus, Bahia, Brazil
| | - Roberta Borges Silva
- Faculty of Human Nutrition, University of Brasilia, Distrito Federal, Brasília, Brazil
| | | | | | | | - Amanda Oliveira Lyrio
- Faculty of Health Sciences, University of Brasilia, Distrito Federal, Brasília, Brazil
| | - Elivan Silva Souza
- Faculty of Medicine, University of Brasilia, Distrito Federal, Brasília, Brazil
| | | | - Peter Michael Loomer
- School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Simone Seixas da Cruz
- Department of Health, Feira de Santana State University, Bahia, Brazil.,Health Sciences Center, Federal University of Recôncavo of Bahia, Santo Antônio de Jesus, Bahia, Brazil
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Moncunill-Mira J, Brunet-Llobet L, Cuadras D, Lorente-Colomé N, Pascal R, Rovira C, Nadal A, Miranda-Rius J. Do the clinical criteria used to diagnose periodontitis affect the association with prematurity? Odontology 2020; 109:455-463. [PMID: 33128123 DOI: 10.1007/s10266-020-00562-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/18/2020] [Indexed: 01/09/2023]
Abstract
In recent years, several studies have examined the possible relationship between periodontal disease in pregnant women and preterm birth. One of the difficulties facing these studies is the heterogeneity of the clinical criteria used to define periodontitis. The aim of this cross-sectional study was to determine the degree of association between maternal periodontitis and preterm birth according to different consensus definitions of periodontal disease. In a study of 146 mothers (60 with preterm births and 86 with term deliveries) at the Sant Joan de Déu Maternal and Children's Hospital in Barcelona, a periodontal examination was carried out within 2 days of birth and the presence of periodontal disease was evaluated using the main clinical classifications published in the literature. The prevalence of periodontitis ranged from 25.4 to 52.1%, depending on the criteria used for its definition. Using the most restrictive criteria, pregnant women with periodontitis had a higher risk of preterm birth (OR: 7.49; p < 0.001) and premature rupture of membranes (OR: 2.49; p = 0.017). Premature infants born to mothers with periodontitis presented a tendency toward low weight, adjusted for gestational age (OR: 3.32; p = 0.065). Our findings suggest that the association between periodontitis and preterm birth is influenced by the definitions of periodontitis used.
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Affiliation(s)
- Jordi Moncunill-Mira
- Department of Dentistry, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg), Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
| | - Lluís Brunet-Llobet
- Department of Dentistry, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg), Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
| | - Daniel Cuadras
- Statistics Unit, Fundació Sant Joan de Déu (FSJD), Barcelona, Spain
| | - Núria Lorente-Colomé
- BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Sant Joan de Déu - University of Barcelona, Barcelona, Spain
| | - Rosalia Pascal
- BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Sant Joan de Déu - University of Barcelona, Barcelona, Spain
| | - Carlota Rovira
- Department of Pathology, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Alfons Nadal
- Department of Pathology, Hospital Clínic, Agust Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Jaume Miranda-Rius
- Department of Dentistry, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain. .,Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg), Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain. .,Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona, Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.
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Radochova V, Stepan M, Kacerovska Musilova I, Slezak R, Vescicik P, Menon R, Jacobsson B, Kacerovsky M. Association between periodontal disease and preterm prelabour rupture of membranes. J Clin Periodontol 2019; 46:189-196. [PMID: 30638274 DOI: 10.1111/jcpe.13067] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 12/21/2018] [Accepted: 01/09/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Periodontal disease is a possible contributing factor to preterm delivery. The aim of this study was to compare the periodontal status of women with preterm prelabour rupture of membranes (PPROM) and women with uncomplicated singleton pregnancies. PATIENTS AND METHODS Seventy-eight women with PPROM at gestational ages between 24 + 0 and 36 + 6 weeks and 77 healthy women with uncomplicated pregnancies, matched for gestational age at sampling without preterm birth, were included in this study. All women underwent evaluation of periodontal and oral hygiene status. RESULTS Women with PPROM had higher gingival and plaque indexes in crude analysis (gingival index: median 0.80 versus 0.20; p < 0.0001; plaque index: median 0.80 versus 0.10; p < 0.0001), even after adjustment for smoking status (p < 0.0001 and p < 0.0001). Mean clinical attachment loss (CAL) and probing pocket depth (PPD) values were higher in women with PPROM in the crude analysis (CAL: median 2.3 mm versus 1.8 mm; p < 0.0001; PPD: median 2.3 mm versus 1.8; p < 0.0001), as well as after adjustment for smoking status (p < 0.0001 and p < 0.0001). CONCLUSIONS Pregnant women with PPROM residing in central Europe had worse periodontal status than women with uncomplicated pregnancies.
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Affiliation(s)
- Vladimira Radochova
- Department of Dentistry, Faculty of Medicine in Hradec Kralove, University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Martin Stepan
- Department of Obstetrics and Gynecology, Faculty of Medicine in Hradec Kralove, University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Ivana Kacerovska Musilova
- Department of Obstetrics and Gynecology, Faculty of Medicine in Hradec Kralove, University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Radovan Slezak
- Department of Dentistry, Faculty of Medicine in Hradec Kralove, University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Peter Vescicik
- Department of Obstetrics and Gynecology, Faculty of Medicine in Hradec Kralove, University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Ramkumar Menon
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine & Perinatal Research, The University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Domain of Health Data and Digitalization, Norwegian Institute of Public Health, Oslo, Norway
| | - Marian Kacerovsky
- Department of Obstetrics and Gynecology, Faculty of Medicine in Hradec Kralove, University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.,Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
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Lafaurie GI, Gómez LA, Montenegro DA, De Avila J, Tamayo MC, Lancheros MC, Quiceno J, Trujillo TG, Noriega LA, Grueso ML, Cepeda K. Periodontal condition is associated with adverse perinatal outcomes and premature rupture of membranes in low-income pregnant women in Bogota, Colombia: a case-control study. J Matern Fetal Neonatal Med 2018; 33:16-23. [PMID: 29852806 DOI: 10.1080/14767058.2018.1484092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Objectives: To assess the periodontal condition as a factor associated with adverse perinatal outcomes, premature rupture of membranes (PRM), and preeclampsia in low-income pregnant women treated at public hospitals in Bogotá, Colombia.Methods: Pregnant women with preterm birth (PTB) and low birth weight (LBW) or both conditions (n = 107/428), or only PTB (n = 73/292) or LBW (n = 74/296) or with PRM (n = 98/392) or preeclampsia (n = 76/304) in a ratio of four controls for each case, coming from three hospitals of the public Northern Network of Bogotá, Colombia were studied. Sociodemographic, perinatal adverse outcome history, antenatal care, chronic infections, periodontal condition, threatened abortion, bleeding in the second half of pregnancy, oligohydramnios, diabetes, gestational diabetes, alcohol consumption, hypertension, smoking, alcohol during pregnancy were determined. Logistic regression was conducted to establish factors associated to perinatal adverse outcomes. Multiple correspondence analysis was conducted as secondary analysis.Results: Threatened abortion, absence of antenatal care, hypertension, chronic infections, and periodontal condition were the most important factors associated with perinatal adverse outcomes. The presence of periodontal pockets was associated with LBW OR 2.52 (IC95% 1.36-4.70), PTB OR 2.04 (IC95% 1.10-3.64), PTB-LBW or both OR 2.08 (IC95% 1.18-3.31), PRM OR 2.04 (IC95% 1.17-3.56). Periodontal pockets presence was not associated with preeclampsia. Multiple correspondence analyses showed high correlation between PRM with chronic infection and presence of periodontal pockets.Conclusions: Periodontal condition is a factor independent of other important risk factors for a perinatal adverse outcome and PRM. Prevention of periodontal disease should be included in preconception and prenatal care programs.
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Affiliation(s)
- Gloria Inés Lafaurie
- Unit of Basic Oral Investigation - UIBO, School of Dentistry, Universidad El Bosque, Bogota, Colombia
| | - Luz Amparo Gómez
- Unit of Basic Oral Investigation - UIBO, School of Dentistry, Universidad El Bosque, Bogota, Colombia
| | | | - Juliette De Avila
- Unit of Basic Oral Investigation - UIBO, School of Dentistry, Universidad El Bosque, Bogota, Colombia
| | - Martha Cecilia Tamayo
- Unit of Basic Oral Investigation - UIBO, School of Dentistry, Universidad El Bosque, Bogota, Colombia
| | | | - Johanna Quiceno
- Unit of Basic Oral Investigation - UIBO, School of Dentistry, Universidad El Bosque, Bogota, Colombia
| | - Tamy Goretty Trujillo
- Unit of Basic Oral Investigation - UIBO, School of Dentistry, Universidad El Bosque, Bogota, Colombia
| | - Luis Antonio Noriega
- Unit of Basic Oral Investigation - UIBO, School of Dentistry, Universidad El Bosque, Bogota, Colombia
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10
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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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11
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Gesase N, Miranda-Rius J, Brunet-Llobet L, Lahor-Soler E, Mahande MJ, Masenga G. The association between periodontal disease and adverse pregnancy outcomes in Northern Tanzania: a cross-sectional study. Afr Health Sci 2018; 18:601-611. [PMID: 30602993 PMCID: PMC6307003 DOI: 10.4314/ahs.v18i3.18] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background For the past two decades, studies have investigated the relationship between periodontal disease and adverse pregnancy outcomes such as pre-eclampsia, preterm birth, low birth weight and preterm premature rupture of membranes. Objectives To determine the prevalence of periodontal disease and associated adverse pregnancy outcomes among women delivering at the Kilimanjaro Christian Medical Centre (KCMC). Methods This cross-sectional study was based on the use of patients' files, clinical examinations and oral interviews with mothers who delivered at the KCMC. Pregnant women with singleton babies (N=1117) who delivered at the KCMC were recruited for the study. Intra-oral examination was performed within five days of birth. The Community Periodontal Index was used to assess periodontal disease Results The prevalence of periodontal disease was 14.2%. Periodontal disease was significantly associated with higher odds of pre-eclampsia [adjusted Odds Ratio 95% Confidence Interval (aOR=4.12;95%CI:2.20–7.90)], low birth weight (aOR=2.41;95%-CI:1.34–4.33) and preterm birth (aOR=2.32;95%CI:1.33–4.27). There was no significant association between periodontal disease and preterm premature rupture of membranes (aORs 1.83;95%CI:0.75–4.21) and eclampsia (3.71;95%CI:0.80–17.13). Conclusion Maternal periodontal disease is a potential independent risk indicator for pre-eclampsia, low birth weight, and preterm birth. Periodontal assessment and therapy should form part of the preventive antenatal care provided to women in developing countries.
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Affiliation(s)
- Nyobasi Gesase
- Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre (KCMC)/Kilimanjaro Christian Medical University College (KCMU College), Moshi, Tanzania
| | - Jaume Miranda-Rius
- Department of Odontostomatology. Faculty of Medicine and Health Sciences. Universitat de Barcelona, Barcelona, Spain
- Hospital Dentistry & Periodontal Medicine Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), Fundació Sant Joan de Déu, Barcelona, Spain
| | - Lluís Brunet-Llobet
- Hospital Dentistry & Periodontal Medicine Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), Fundació Sant Joan de Déu, Barcelona, Spain
- Division of Pediatric Dentistry. Hospital Universitari Sant Joan de Déu. Universitat de Barcelona, Barcelona, Spain
| | - Eduard Lahor-Soler
- Department of Odontostomatology. Faculty of Medicine and Health Sciences. Universitat de Barcelona, Barcelona, Spain
- Hospital Dentistry & Periodontal Medicine Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), Fundació Sant Joan de Déu, Barcelona, Spain
| | - Michael J Mahande
- Department of Epidemiology and Biostatistics. Institute of Public Health. Kilimanjaro Christian Medical University College (KCMU College), Moshi, Tanzania
| | - Gileard Masenga
- Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre (KCMC)/Kilimanjaro Christian Medical University College (KCMU College), Moshi, Tanzania
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12
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Komine-Aizawa S, Aizawa S, Hayakawa S. Periodontal diseases and adverse pregnancy outcomes. J Obstet Gynaecol Res 2018; 45:5-12. [PMID: 30094895 DOI: 10.1111/jog.13782] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 07/13/2018] [Indexed: 12/14/2022]
Abstract
From last decade of the 20th century, numerous epidemiological studies and intervention trials have attempted to prove the relationships between maternal periodontal diseases and adverse pregnancy outcomes (APO). Periodontal diseases are considered a risk factor for APO, including preterm birth, fetal growth restriction, low birthweight, pre-eclampsia and gestational diabetes. However, the efficacy of periodontal treatment during pregnancy is controversial. Two pathogenic mechanisms might explain the potential effect of periodontal diseases on pregnancy outcomes. First, periodontal bacteria originating in the gingival biofilm directly affect the feto-placental unit subsequent to bacteremia. Second, inflammatory mediators secreted by the subgingival inflammatory site are carried to the feto-placental unit, where they then cause an inflammatory response. To elucidate these mechanisms, many researchers have been investigating the use of experimental animal models and in vitro models. In the present review, we summarize the current literature on the relationship between periodontal diseases and APO from epidemiological studies, animal models studies and in vitro studies, and speculate on the possible mechanism of periodontal diseases affecting pregnancy outcomes.
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Affiliation(s)
- Shihoko Komine-Aizawa
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Sohichi Aizawa
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan.,Department of Oral Surgery, JCHO Yokohama Chuo Hospital, Kanagawa, Japan
| | - Satoshi Hayakawa
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
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13
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Wagle M, D'Antonio F, Reierth E, Basnet P, Trovik TA, Orsini G, Manzoli L, Acharya G. Dental caries and preterm birth: a systematic review and meta-analysis. BMJ Open 2018; 8:e018556. [PMID: 29500202 PMCID: PMC5855295 DOI: 10.1136/bmjopen-2017-018556] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/24/2017] [Accepted: 01/12/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The primary objective of this systematic review was to evaluate the association between dental caries and preterm birth (PTB). The secondary objective was ascertaining the difference between women with dental caries who experienced PTB and those who did not with regard to decayed, missing and filled teeth (DMFT), and decayed, missing and filled surfaces (DMFS) indices. METHODS MEDLINE, Embase, CINAHL and Cochrane databases were searched initially in November 2015 and repeated in December 2016. We included observational cohort and case-control studies. Only studies reporting the risk of PTB in women affected compared with those not affected by dental caries in pregnancy were included. Random-effect meta-analyses were used to compute the summary OR of PTB among women with caries versus women without caries, and the mean difference in either DMFT or DMFS indices between women experiencing PTB and those without PTB. RESULTS Nine observational studies (4826 pregnancies) were included. Women affected by dental caries during pregnancy did not show a significantly higher risk of PTB (OR: 1.16, 95% CI 0.90 to 1.49, P=0.25, I2=35%). Also, the women with PTB did not show significantly higher DMFT or DMFS indices (summary mean differences: 1.56, P=0.10; I2=92% and -0.15, P=0.9, I2=89%, respectively). CONCLUSION Dental caries does not appear to be a substantial risk factor for PTB. TRIAL REGISTRATION NUMBER NCT01675180; Pre-results.
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Affiliation(s)
- Madhu Wagle
- Department of Clinical Medicine, Faculty of Health Sciences, Women's Health and Perinatology Research Group, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Francesco D'Antonio
- Department of Clinical Medicine, Faculty of Health Sciences, Women's Health and Perinatology Research Group, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
- Department of Obstetrics and Gynaecology, University Hospital of Northern Norway, Tromsø, Norway
| | - Eirik Reierth
- Science and Health Library, University Library, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Purusotam Basnet
- Department of Clinical Medicine, Faculty of Health Sciences, Women's Health and Perinatology Research Group, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
- Department of Obstetrics and Gynaecology, University Hospital of Northern Norway, Tromsø, Norway
| | - Tordis A Trovik
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Ancona, Italy
| | - Lamberto Manzoli
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Ganesh Acharya
- Department of Clinical Medicine, Faculty of Health Sciences, Women's Health and Perinatology Research Group, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
- Center for Fetal Medicine, Karolinska University Hospital, Stockholm, Sweden
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14
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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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15
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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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16
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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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17
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Radochova V, Kacerovska Musilova I, Stepan M, Vescicik P, Slezak R, Jacobsson B, Kacerovsky M. Periodontal disease and intra-amniotic complications in women with preterm prelabor rupture of membranes. J Matern Fetal Neonatal Med 2017; 31:2852-2861. [PMID: 28724342 DOI: 10.1080/14767058.2017.1358265] [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] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Periodontal disease is frequently suggested as a possible causal factor for preterm delivery. The link between periodontal disease and preterm delivery is a possible translocation of periopathogenic bacteria to the placenta and amniotic fluid as well as a systemic response to this chronic inflammatory disease. However, there is a lack of information on whether there is an association between clinical periodontal status in women with preterm prelabor rupture of membranes (PPROM) and the presence of microbial invasion of the amniotic cavity (MIAC) and intra-amniotic inflammation (IAI). Therefore, the main aim of this study was to evaluate the incidence and severity of periodontal disease in women with PPROM. The secondary aim was to characterize an association between periodontal status and the presence of intra-amniotic PPROM complications (MIAC and/or IAI). MATERIALS AND METHODS Seventy-eight women with PPROM at gestational ages between 24 + 0 and 36 + 6 weeks were included in this study. The samples of amniotic fluid were obtained at admission via transabdominal amniocentesis, and amniotic fluid interleukin (IL)-6 concentrations were determined using a point-of-care test. All women had a full-mouth recording to determine the periodontal and oral hygiene status. Probing pocket depth and clinical attachment loss were measured at four sites on each fully erupted tooth. RESULTS In total, 45% (35/78) of women with PPROM had periodontal disease. Mild, moderate, and severe periodontal disease was present in 19% (15/78), 19% (15/78), and 6% (5/78) of women, respectively. The presence of MIAC and IAI was found in 28% (22/78) and 26% (20/78) of women, respectively. Periopathogenic bacteria (2 × Streptococcus intermedius and 1 × Fusobacterium nucleatum) was found in the amniotic fluid of 4% (3/78) of women. There were no differences in periodontal status between women with MIAC and/or IAI and women without these intra-amniotic complications. CONCLUSIONS The presence of MIAC and IAI was not related to the periodontal status of women with PPROM.
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Affiliation(s)
- Vladimira Radochova
- a Department of Dentistry, Charles University, Faculty of Medicine in Hradec Kralove , University Hospital in Hradec Králové , Hradec Králové , Czech Republic
| | - Ivana Kacerovska Musilova
- b Department of Obstetrics and Gynecology, Charles University, Faculty of Medicine in Hradec Kralove , University Hospital in Hradec Králové , Hradec Králové , Czech Republic
| | - Martin Stepan
- b Department of Obstetrics and Gynecology, Charles University, Faculty of Medicine in Hradec Kralove , University Hospital in Hradec Králové , Hradec Králové , Czech Republic
| | - Peter Vescicik
- b Department of Obstetrics and Gynecology, Charles University, Faculty of Medicine in Hradec Kralove , University Hospital in Hradec Králové , Hradec Králové , Czech Republic
| | - Radovan Slezak
- a Department of Dentistry, Charles University, Faculty of Medicine in Hradec Kralove , University Hospital in Hradec Králové , Hradec Králové , Czech Republic
| | - Bo Jacobsson
- c Department of Obstetrics and Gynecology , Sahlgrenska Academy, Gothenburg University , Gothenburg , Sweden.,d Domain of Health Data and Digitalization , Norwegian Institute of Public Health , Oslo , Norway
| | - Marian Kacerovsky
- b Department of Obstetrics and Gynecology, Charles University, Faculty of Medicine in Hradec Kralove , University Hospital in Hradec Králové , Hradec Králové , Czech Republic.,e Biomedical Research Center, University Hospital Hradec Králové , Hradec Králové , Czech Republic
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18
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Abstract
BACKGROUND Periodontal disease (PD) is a multifactorial inflammatory condition in which inappropriate interaction between the host immune response and specific groups of bacterial pathogens leads to destruction of connective and bone tissues supporting the tooth. Dissemination of pathogens, toxins, and immune complexes from and to periodontal lesions is at the basis of the increasingly recognized association between PD and various systemic diseases (SDs). Considering the growing attention of the medical community to "gender medicine", this review focuses on the association between PD and six systemic conditions heavily impacting women's health, with the aim of providing evidence in support of a joint effort between physicians and dentists to improve clinical management of these conditions. METHODS We considered systematic reviews, meta-analyses and narrative reviews evaluating all possible associations between periodontitis, systemic diseases and women. RESULTS Gender prevalence for PD is discordant, but the literature strongly supports an association between PD and female infertility and adverse pregnancy outcomes. Moreover, PD is bidirectionally linked to several systemic diseases characterized by an established female gender bias, i.e. osteoporosis (OP), cardiovascular diseases (CVD), autoimmunity, Alzheimer's disease (AD) and cancer. CONCLUSIONS Overall, the literature data reviewed here provides a strong foundation for further characterization of molecular and microbial drivers of PD and of several female-prevalent systemic diseases, highlighting the possible importance of a good oral condition in preventing or attenuating women's systemic diseases.
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Affiliation(s)
| | - Maria Luisa Brandi
- b Universita degli Studi di Firenze , Department of Surgery and Translational Medicine , Florence , Italy
| | | | - Piero Nobili
- c AIMOP Accademia Italiana Medicina Orale e Parodontologia , Milano , Italy
| | - Enzo Medico
- d University of Torino , Department of Oncology , Torino , Italy
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19
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Ren H, Du M. Role of Maternal Periodontitis in Preterm Birth. Front Immunol 2017; 8:139. [PMID: 28243243 PMCID: PMC5303728 DOI: 10.3389/fimmu.2017.00139] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 01/26/2017] [Indexed: 01/22/2023] Open
Abstract
In the last two decades, many studies have focused on whether periodontitis is a risk factor for preterm birth (PTB). However, both epidemiological investigation and intervention trials have reached contradictory results from different studies. What explains the different findings, and how should future studies be conducted to better assess this risk factor? This article reviews recent epidemiological, animal, and in vitro studies as well as intervention trials that evaluate the link between periodontitis and PTB. Periodontitis may act as a distant reservoir of microbes and inflammatory mediators and contribute to the induction of PTB. Animal studies revealed that maternal infections with periodontal pathogens increase levels of circulating IL-1β, IL-6, IL-8, IL-17, and TNF-α and induce PTB. In vitro models showed that periodontal pathogens/byproducts induce COX-2, IL-8, IFN-γ, and TNF-α secretion and/or apoptosis in placental tissues/cells. The effectiveness of periodontal treatment to prevent PTB is influenced by the diagnostic criteria of periodontitis, microbial community composition, severity of periodontitis, treatment strategy, treatment efficiency, and the period of treatment during pregnancy. Although intervention trials reported contradictory results, oral health maintenance is an important part of preventive care that is both effective and safe throughout pregnancy and should be supported before and during pregnancy. As contradictory epidemiological and intervention studies continue to be published, two new ideas are proposed here: (1) severe and/or generalized periodontitis promotes PTB and (2) periodontitis only promotes PTB for pregnant women who are young or HIV-infected or have preeclampsia, pre-pregnancy obesity, or susceptible genotypes.
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Affiliation(s)
- Hongyu Ren
- MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University , Wuhan , China
| | - Minquan Du
- MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University , Wuhan , China
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20
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Turton M, Africa CWJ. Further evidence for periodontal disease as a risk indicator for adverse pregnancy outcomes. Int Dent J 2016; 67:148-156. [PMID: 27988930 DOI: 10.1111/idj.12274] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Although there is increasing evidence to suggest an association between periodontal disease and adverse pregnancy outcomes, the issue remains controversial. STUDY OBJECTIVE This study tested the hypothesis that periodontal disease is a risk indicator for preterm delivery of low-birthweight infants. MATERIALS AND METHODS The study sample comprised 443 pregnant women with a mean (± standard deviation) age of 24.13 (±5.30) years. At first visit, maternal oral health status was assessed by the measurement of probing pocket depth and clinical attachment loss, and periodontal status was graded as absent, mild, moderate or severe. An association was sought between pregnancy outcomes and maternal periodontal status. RESULTS While controlling for other factors, significant associations were found between pregnancy outcomes and maternal periodontal index scores. CONCLUSION This study provides further evidence that periodontal disease is a risk indicator for adverse pregnancy outcomes.
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Affiliation(s)
- Mervyn Turton
- Department of Medical Biosciences, University of the Western Cape, Bellville, Cape Town, South Africa
| | - Charlene W J Africa
- Department of Medical Biosciences, University of the Western Cape, Bellville, Cape Town, South Africa
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21
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Porphyromonas gingivalis lipopolysaccharide inhibits trophoblast invasion in the presence of nicotine. Placenta 2015; 36:27-33. [DOI: 10.1016/j.placenta.2014.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 10/22/2014] [Accepted: 10/29/2014] [Indexed: 12/16/2022]
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Gur TL, Worly BL, Bailey MT. Stress and the commensal microbiota: importance in parturition and infant neurodevelopment. Front Psychiatry 2015; 6:5. [PMID: 25698977 PMCID: PMC4313583 DOI: 10.3389/fpsyt.2015.00005] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 01/12/2015] [Indexed: 12/26/2022] Open
Abstract
The body is colonized by an enormous array of microbes that are collectively called the microbiota. During quiescent periods, microbial communities within the gut are relatively resistant to change. However, several factors that disrupt homeostasis can also significantly change gut microbial community structure. One factor that has been shown to change the composition of the gut microbiota is exposure to psychological stressors. Studies demonstrate that the commensal microbiota are involved in stressor-induced immunomodulation, but other biological effects are not yet known. This review discusses emerging evidence that the microbiota can impact the brain and behavior and indicates that stressor-induced alterations in the composition of gut microbial communities contribute to stressor-induced behavioral changes. This review will also discuss the evidence that such effects are most evident early in life, where both stress and the microbiota have been linked to birth outcomes, such as prematurity, and neurodevelopment. When considered together, a paradigm emerges in which stressor-induced alterations in commensal microbial populations significantly impact parturition and infant neurodevelopment.
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Affiliation(s)
- Tamar L Gur
- Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center , Columbus, OH , USA ; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center , Columbus, OH , USA ; Department of Neuroscience, The Ohio State University Wexner Medical Center , Columbus, OH , USA
| | - Brett L Worly
- Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center , Columbus, OH , USA ; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center , Columbus, OH , USA
| | - Michael T Bailey
- Division of Biosciences, College of Dentistry, The Ohio State University , Columbus, OH , USA ; Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center , Columbus, OH , USA ; Department of Pediatrics, The Ohio State University Wexner Medical Center , Columbus, OH , USA ; Comprehensive Cancer Center, The Ohio State University Wexner Medical Center , Columbus, OH , USA
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Stadelmann PFM, Eick S, Salvi GE, Surbek D, Mohr S, Bürgin W, Ramseier CA, Sculean A. Increased periodontal inflammation in women with preterm premature rupture of membranes. Clin Oral Investig 2014; 19:1537-46. [PMID: 25420538 DOI: 10.1007/s00784-014-1371-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 11/14/2014] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To evaluate possible differences in periodontal inflammatory, microbiological and clinical parameters between women with preterm premature rupture of membranes (PPROM) and controls with uncomplicated pregnancies. MATERIALS AND METHODS Fifty-six women (32 test (PPROM) and 24 controls (uncomplicated pregnancies)) were examined at three time-points (T1: gestational weeks 20-35, T2: within 48 h after parturition, T3: 4-6 weeks after parturition). The examinations included assessment of the Periodontal Screening Index, collection of gingival crevicular fluid (GCF) and subgingival as well as vaginal bacterial sampling. RESULTS Periodontal inflammation was found to be higher in the test compared with the control group (p < 0.05) and decreased over time in both groups (p < 0.05). Microbiological outcomes showed no intergroup differences (p > 0.05) in prevalence of bacteria, but a decrease in subgingival periodontopathogens from T1 to T2 in the test group (p < 0.05) was observed. Interleukin (IL)-1β levels in GCF at T2 were not different between groups (p > 0.05). In women with PPROM, GCF levels of IL-8 (p < 0.05) and C-reactive protein (p < 0.05) were lower and IL-10 levels higher (p < 0.05) compared with controls. CONCLUSIONS Periodontal inflammation is elevated during pregnancy and seems to be more pronounced in women with PPROM. CLINICAL RELEVANCE The findings of the present study revealed an association between periodontal inflammation and PPROM, thus emphasizing the importance of optimizing self-performed oral hygiene in pregnant women.
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Affiliation(s)
- Pascale F M Stadelmann
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
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Affiliation(s)
- Naoko Hirohata
- Nihon University Graduate School of Medicine, the Pathology Program; Infection Control and Prevention
| | - Sohichi Aizawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Nihon University School of Medicine
| | - Naoko Hirohata
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine
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Abstract
PURPOSE OF REVIEW This review aims to interpret the current literature on the role of genetic and epigenetic factors in susceptibility to neonatal infection, a leading cause of early life mortality and morbidity. RECENT FINDINGS Epidemiological data indicate that the differential susceptibility to infection is partly heritable. To date there have been relatively few studies on genetic determinants of susceptibility to neonatal infection and many of these have methodological shortcomings. Most studies predominantly focus on the innate immune system. There is growing interest in the potential role of epigenetic mechanisms in disease susceptibility and data are emerging on the role of epigenetics in the maturation of the immune system in early life. SUMMARY Infection is a leading cause of morbidity and mortality, especially in preterm infants, but it remains unclear why neonates are so susceptible or what mediates differential risk. Genetic and epigenetic epidemiologic studies may assist in the identification of critical protective and pathogenic pathways. Despite the current relative lack of robust data, such studies may facilitate the development of interventions that ultimately decrease the significant morbidity and mortality of this highly vulnerable population.
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Sgolastra F, Petrucci A, Severino M, Gatto R, Monaco A. Relationship between periodontitis and pre-eclampsia: a meta-analysis. PLoS One 2013; 8:e71387. [PMID: 23990948 PMCID: PMC3747173 DOI: 10.1371/journal.pone.0071387] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 07/01/2013] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Studies have suggested controversial results regarding a possible association between pre-eclampsia (PE) and periodontal disease (PD) and no meta-analysis has been performed to clarify this issue. METHODS A literature search of electronic databases was performed for articles published through March 24, 2013, followed by a manual search of several dental and medical journals. The meta-analysis was conducted according to the recommendations of the Cochrane Collaboration and PRISMA. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed with the χ(2)-based Cochran Q test and I(2) statistic. The level of significance was set at P <0.05. RESULTS Fifteen studies were included, including three cohort and 12 case-control studies. A positive association was found between PE and PD (OR 2.17, 95% CI 1.38-3.41, P = 0.0008). However, a high and significant heterogeneity was found (χ(2) = 62.42, P<0.00001, I(2) = 75%). In most cases, subgroup analysis had low power to detect significant differences between PE and non-PE groups. CONCLUSION Based on the findings of the meta-analysis, PD appears to be a possible risk factor for PE. However, given the important differences in the definitions and diagnoses of PD and PE among the studies, as well as their lack of good methodological quality, future trials are needed to confirm the results of the present meta-analysis.
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Affiliation(s)
- Fabrizio Sgolastra
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ambra Petrucci
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Marco Severino
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Roberto Gatto
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Annalisa Monaco
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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Villa A, Abati S, Pileri P, Calabrese S, Capobianco G, Strohmenger L, Ottolenghi L, Cetin I, Campus GG. Oral health and oral diseases in pregnancy: a multicentre survey of Italian postpartum women. Aust Dent J 2013; 58:224-9. [PMID: 23713644 DOI: 10.1111/adj.12058] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this study was to explore the oral hygiene practices and oral health status of Italian postpartum women. METHODS A self-administered questionnaire assessed socio-demographic information, oral hygiene habits and frequency of dental visits. All women received a thorough oral examination within five days after delivery. Logistic regression models were used to estimate odds ratios and 95% confidence intervals for exposures of interest and the presence of 'severe' periodontitis. RESULTS Seven hundred and fifty women participated in the study; 99.1% brushed their teeth everyday and 59.9% visited the dentist annually. The mean frequency of sites with bleeding on probing was 16.1% and the median clinical attachment level was 2.1 mm. The mean caries experience score (DMFT) was 8. Severe periodontal disease was present in 21.9% of individuals. Patients who reported visiting a dentist only when in pain and women with three dental caries or more were significantly more likely to have periodontitis (OR: 1.6; 95% CI: 1.1-2.2; p < 0.05 and OR: 2.3; 95% CI: 1.5-3.5; p < 0.01, respectively). CONCLUSIONS Given the possible association between maternal and infant oral health, and between periodontal infection and general health, antenatal care providers should collaborate with dentists to encourage all pregnant women to comply with the oral health professionals' recommendations regarding appropriate dental brushing techniques and the importance of dental visits.
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Affiliation(s)
- A Villa
- Dental Clinic, Department of Health Sciences, University of Milan, Italy.
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