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Butera A, Pascadopoli M, Nardi MG, Ogliari C, Chiesa A, Preda C, Perego G, Scribante A. Clinical Use of Paraprobiotics for Pregnant Women with Periodontitis: Randomized Clinical Trial. Dent J (Basel) 2024; 12:116. [PMID: 38668028 PMCID: PMC11049446 DOI: 10.3390/dj12040116] [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: 01/25/2024] [Revised: 03/26/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Periodontal disease is very common in pregnant women. Paraprobiotics are a subset of probiotics. They can be defined as inactivated microbial cells providing health benefits to the host and are considered particularly safe. The aim of this study was to compare the periodontal health of pregnant women and puerperae after 6 months of home use of paraprobiotics. A total of 30 pregnant women were enrolled and divided into two groups: the test group, who had to use a paraprobiotic-based toothpaste (Biorepair Peribioma Pro, Coswell S.p.A., Funo di Argelato, BO, Italy) and mousse (Mousse Mouthwash Biorepair Peribioma, Coswell S.p.A.) twice a day, and the control group, who had to use only the paraprobiotic-based toothpaste. The time frames of the study were: 1 month (T1), 3 months (T2) and 6 months (T3), and data were collected during pregnancy and in the period immediately following delivery. The following indices were evaluated at T0, T1, T2 and T3: clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BOP), plaque control record (PCR), modified marginal gingival index (mMGI), papillary marginal gingival index (PMGI) and recessions (R). All data were subjected to statistical analysis. PCR decreased significantly from T0 to T1 in the control group and from T0 to T2 and from T0 to T3 in the test group. BOP tended to decrease in both groups, but a significant reduction was observed only in the test group. CAL, PPD, PMGI and mMGI tended to decrease gradually in both groups without significant differences between or within groups. The combination of the paraprobiotic-based toothpaste and the paraprobiotic-based mousse significantly reduced BoP and plaque control over time, although there were no significant differences with the use of the paraprobiotic-based toothpaste alone. In addition, the combination of the two products promoted a trend towards the better stabilization of recessions.
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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
| | - Maurizio Pascadopoli
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Maria Gloria Nardi
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | | | - Alessandro Chiesa
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Camilla Preda
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Giulia Perego
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Andrea Scribante
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- 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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Yamazaki A, Ogura K, Minami K, Ogai K, Horiguchi T, Okamoto S, Mukai K. Oral microbiome changes associated with the menstrual cycle in healthy young adult females. Front Cell Infect Microbiol 2023; 13:1119602. [PMID: 37065196 PMCID: PMC10102642 DOI: 10.3389/fcimb.2023.1119602] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/20/2023] [Indexed: 04/03/2023] Open
Abstract
The relationship between the menstrual cycle and the oral microbiome has not been clarified. The purpose of this study was to assess potential changes in the oral microbiome of healthy young adults using 16S rRNA-based sequencing. Eleven females (aged 23–36 years) with stable menstrual cycles and without any oral problems were recruited. Saliva samples were collected before brushing every morning during the menstrual period. Based on basal body temperatures, menstrual cycles were divided into four phases, namely the menstrual, follicular, early luteal, and late luteal phases. Our results showed that the follicular phase had a significantly higher abundance ratio of the Streptococcus genus than the early and late luteal phases, whereas the abundance ratios of the Prevotella 7 and Prevotella 6 genera were significantly lower in the follicular phase than those in the early and late luteal phases and that in the early luteal phase, respectively. Alpha diversity by the Simpson index was significantly lower in the follicular phase than that in the early luteal phase, and beta diversity showed significant differences among the four phases. Using the relative abundance data and copy numbers of the 16S rRNA genes in the samples, the bacterial amounts in the four phases were compared, and we observed that the follicular phase had significantly lower amounts of the Prevotella 7 and Prevotella 6 genera than the menstrual and early luteal phase, respectively. These results indicate reciprocal changes with the Streptococcus genus and Prevotella genera, particularly in the follicular phase. In the present study, we showed that the oral microbiome profiles are affected by the menstrual cycles of healthy young adult females.
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Affiliation(s)
- Ayaka Yamazaki
- Division of Transdisciplinary Sciences, Graduate School of Frontier Science Initiative, Kanazawa University, Kanazawa, Japan
| | - Kohei Ogura
- Advanced Health Care Science Research Unit, Innovative Integrated Bio-Research Core, Institute for Frontier Science Initiative, Kanazawa University, Kanazawa, Japan
| | - Kana Minami
- Department of Health Development Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Kazuhiro Ogai
- AI Hospital/Macro Signal Dynamics Research and Development Center, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Tomomi Horiguchi
- Department of Clinical Nursing, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Shigefumi Okamoto
- Advanced Health Care Science Research Unit, Innovative Integrated Bio-Research Core, Institute for Frontier Science Initiative, Kanazawa University, Kanazawa, Japan
- Department of Clinical Laboratory Sciences, Faculty of Health Sciences, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Kanae Mukai
- Department of Clinical Nursing, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
- *Correspondence: Kanae Mukai,
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Ortmann N, Möllers M, Braun J, Sourouni M, Willy D, Köster HA, Klockenbusch W, Schmitz R, Oelmeier K. Periodontal disease in pregnancy: A comparative prospective study. Z Geburtshilfe Neonatol 2023. [PMID: 36758609 DOI: 10.1055/a-2008-1038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Periodontal disease affects many pregnant women and may be associated with adverse pregnancy outcomes. The object of this study was to evaluate women's level of knowledge about this condition in pregnancy. We compared level of knowledge, participation in medical screening, and periodontal health status in pregnant women and nonpregnant controls. MATERIAL AND METHODS This study included 141 pregnant and 141 nonpregnant women, examined by one examiner at the Department of Gynecology and Obstetrics of the University Hospital Muenster, Germany. With reference to periodontal health status, the Periodontal Screening Index was used and a questionnaire was designed to represent the level of knowledge and predisposing factors. RESULTS Pregnant women showed a strong tendency towards higher Periodontal Screening Indices than the nonpregnant controls (P=0.058). A strong positive correlation between participation in screenings and a lower Periodontal Screening Index was measured, but no direct relation between knowledge and periodontal health was detected. However, a better level of knowledge correlated noticeably with participation in screening programs. Educational attainment was found to be a main factor correlated with periodontal health and further factors such as medical screening and smoking habits. A great number of women felt they were not sufficiently informed about oral health aspects in pregnancy. CONCLUSIONS As participation in screenings was a main item that positively correlated with healthier periodontal status, it had to be a focused element. The possible positive influence of knowledge regarding the participation in screening programs showed not only the need to spread awareness but also the need for proper education.
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Affiliation(s)
- Nora Ortmann
- Dentists, Dental Surgery Dr. Stephan Dornbusch, Bottrop, Germany.,Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| | - Mareike Möllers
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| | - Janina Braun
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| | - Marina Sourouni
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| | - Daniela Willy
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| | - Helen Ann Köster
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| | - Walter Klockenbusch
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| | - Ralf Schmitz
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
| | - Kathrin Oelmeier
- Department of Gynecology and Obstetrics, University Hospital Munster, Munster, Germany
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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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Jang H, Patoine A, Wu TT, Castillo DA, Xiao J. Oral microflora and pregnancy: a systematic review and meta-analysis. Sci Rep 2021; 11:16870. [PMID: 34413437 PMCID: PMC8377136 DOI: 10.1038/s41598-021-96495-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 08/02/2021] [Indexed: 02/07/2023] Open
Abstract
Understanding changes in oral flora during pregnancy, its association to maternal health, and its implications to birth outcomes is essential. We searched PubMed, Embase, Web of Science, and Cochrane Library in May 2020 (updated search in April and June 2021), and conducted a systematic review and meta-analyses to assess the followings: (1) oral microflora changes throughout pregnancy, (2) association between oral microorganisms during pregnancy and maternal oral/systemic conditions, and (3) implications of oral microorganisms during pregnancy on birth outcomes. From 3983 records, 78 studies were included for qualitative assessment, and 13 studies were included in meta-analysis. The oral microflora remains relatively stable during pregnancy; however, pregnancy was associated with distinct composition/abundance of oral microorganisms when compared to postpartum/non-pregnant status. Oral microflora during pregnancy appears to be influenced by oral and systemic conditions (e.g. gestational diabetes mellitus, pre-eclampsia, etc.). Prenatal dental care reduced the carriage of oral pathogens (e.g. Streptococcus mutans). The Porphyromonas gingivalis in subgingival plaque was more abundant in women with preterm birth. Given the results from meta-analyses were inconclusive since limited studies reported outcomes on the same measuring scale, more future studies are needed to elucidate the association between pregnancy oral microbiota and maternal oral/systemic health and birth outcomes.
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Affiliation(s)
- Hoonji Jang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Alexa Patoine
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, USA
| | - Daniel A Castillo
- Miner Library, University of Rochester Medical Center, Rochester, NY, USA
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
- Perinatal Oral Health, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, 14620, USA.
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Evans RDR, Cooke W, Hemmila U, Calice-Silva V, Raimann J, Craik A, Mandula C, Mvula P, Msusa A, Dreyer G, Levin NW, Pecoits-Filho R. A Salivary Urea Nitrogen Dipstick to Detect Obstetric-Related Acute Kidney Disease in Malawi. Kidney Int Rep 2017; 3:178-184. [PMID: 29340329 PMCID: PMC5762969 DOI: 10.1016/j.ekir.2017.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 09/24/2017] [Accepted: 10/02/2017] [Indexed: 02/02/2023] Open
Abstract
Introduction Obstetric-related acute kidney injury (AKI) is associated with adverse outcomes for mother and fetus, particularly in low-income countries. However, laboratory-independent tools to facilitate diagnosis are lacking. We assessed the diagnostic performance of a salivary urea nitrogen (SUN) dipstick to detect obstetric-related acute kidney disease in Malawi. Methods Women at high risk for AKI admitted to an obstetric unit in Blantyre, Malawi, were recruited between 21 September and 11 December 2015. Patients underwent serum creatinine (SCr) testing alongside measurement of SUN using a dipstick on admission, and every 48 hours thereafter if evidence of kidney disease was found. Results A total of 301 patients were included (mean age 25.9 years, 11% HIV positive). Of the patients, 23 (7.6%) had AKI, stage 1 in 47.8%, most commonly due to preeclampsia/eclampsia. Mean presenting SCr values were 108.8 ± 21.8 μmol/l (1.23 ± 0.25 mg/dl), 118 ± 34.45 μmol/l (1.33 ± 0.39 mg/dl), and 136.1 ± 30.4 μmol/l (1.54 ± 0.34 mg/dl) in AKI stages 1 to 3 respectively. SUN > 14 mg/dl had a sensitivity of 12.82% and a specificity of 97.33% to detect acute kidney disease; the area under the receiver operating characteristic curve was 0.551. In patients with normal SUN on admission, perinatal mortality was 11.8%, and was 25.0% if SUN was > 14 mg/dl (P = 0.18). Conclusion The SUN dipstick was specific but insensitive when used to diagnose obstetric-related AKI. Limited biochemical derangement and low salivary urea concentrations due to physiological changes in pregnancy, as opposed to a technical limitation of the dipstick itself, are the likely reason for the lack of sensitivity in this study.
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Affiliation(s)
- Rhys D R Evans
- University of Malawi College of Medicine, Malawi.,University College London Centre for Nephrology, London, UK.,Renal Department, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - William Cooke
- Renal Department, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Ulla Hemmila
- University of Malawi College of Medicine, Malawi.,Renal Department, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Viviane Calice-Silva
- School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.,Pró-rim Foundation, Joinville, Brazil
| | | | - Alison Craik
- Renal Department, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Chimwemwe Mandula
- Renal Department, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Priscilla Mvula
- Obstetric Department, Queen Elizabeth Central Hospital, Malawi
| | - Ausbert Msusa
- University of Malawi College of Medicine, Malawi.,Obstetric Department, Queen Elizabeth Central Hospital, Malawi
| | - Gavin Dreyer
- Renal Department, Queen Elizabeth Central Hospital, Blantyre, Malawi.,Bart's Health, London, UK
| | - Nathan W Levin
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Perinatal Mortality Associated with Positive Postmortem Cultures for Common Oral Flora. Infect Dis Obstet Gynecol 2017; 2017:9027918. [PMID: 28325959 PMCID: PMC5343271 DOI: 10.1155/2017/9027918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/07/2017] [Indexed: 11/25/2022] Open
Abstract
Introduction. To investigate whether maternal oral flora might be involved in intrauterine infection and subsequent stillbirth or neonatal death and could therefore be detected in fetal and neonatal postmortem bacterial cultures. Methods. This retrospective study of postmortem examinations from 1/1/2000 to 12/31/2010 was searched for bacterial cultures positive for common oral flora from heart blood or lung tissue. Maternal age, gestational age, age at neonatal death, and placental and fetal/neonatal histopathological findings were collected. Results. During the study period 1197 postmortem examinations (861 stillbirths and 336 neonatal deaths) were performed in our hospital with gestational ages ranging from 13 to 40+ weeks. Cultures positive for oral flora were identified in 24 autopsies including 20 pure and 8 mixed growths (26/227, 11.5%), found in 16 stillbirths and 8 neonates. Microscopic examinations of these 16 stillbirths revealed 8 with features of infection and inflammation in fetus and placenta. The 7 neonatal deaths within 72 hours after birth grew 6 pure isolates and 1 mixed, and 6 correlated with fetal and placental inflammation. Conclusions. Pure isolates of oral flora with histological evidence of inflammation/infection in the placenta and fetus or infant suggest a strong association between maternal periodontal conditions and perinatal death.
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