Maternal Periodontal Status and Risk of Adverse Pregnancy Outcomes A Case Control Study on Indian Mothers
Maternal Periodontal Status and Risk of Adverse Pregnancy Outcomes
Keywords:
low birth weight; periodontal disease/adverse effects; preterm birth, PGE2, risk factorsAbstract
Objective: This study was conducted to - a) Determine the association, if any between maternal periodontal infection and Preterm Birth low birth weight (PLBW) in Indian population b) Evaluate the correlation ,if any, between the severity of maternal periodontal infection and the birth weight of the neonate. Methods: This Case control study was conducted on 100 mothers. Cases (n=50) were mothers who delivered preterm low birth weight infants (PLBW). Controls were mothers with normal pregnancy outcomes. Periodontal status of the mothers and PGE2 level in the GCF was recorded postpartum. . Multivariate regression models were fitted controlling for common covariates. Results: Multivariate logistic regression models controlling for other risk factors and covariates, demonstrated that maternal localized moderate periodontitis is significantly associated with preterm low birth weight, with an adjusted odds ratio of 3.16 PLBW cases. GCF–PGE2 level provided further evidence for the association and there was negative correlation between the GCF-PGE2 level and birth weight of the infant. Conclusion: The data support the notion that maternal periodontitis is independently associated with preterm low birth weight in Indian population.
References
1.Dadhich JP, Paul VK. State of India’s Newborns.New Delhi/ Washington DC: National Neonatology Forum and Save the Children; 2004.
2. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008;371(9606):75-84.
3. Hillier SL, Krohn MA, Kiviat NB, Watts DH, Eschenbach DA. Microbiologic causes and neonatal outcomes associated withchorioamnion infection. Am J Obstet Gynecol 1991;165:955-61.4.Goldenberg RL, Rouse DJ. Medical progress: Prevention of premature birth. N Engl J Med 1998;339: 313-320[5]
5 . Hill GB. Preterm birth: associations with genital and possibly oral microflora. Ann Periodontol 1998;3:222–32.
6.Gibbs(2001) The Relationship Between Infections and Adverse Pregnancy Outcomes: An Overview Annl Periodontol 2001;6:153-163.
7. Romero R, Mazor M. Infection and preterm labor. Clin Obstet Gynecol 1988;31:553-84
8. Taylor D, Kenyon S, Tarnow-Mordi W (1997). Infection and preterm labour. Br J Obst Gynaecol 104:1338-1340.
9. Brocklehurst P . Infection and preterm delivery. Br Med J 1999; 318:548-549 10 Page RC, Kornman KS . The pathogenesis of human periodontitis. Periodontol 2000 1997 ;14:9-11.
11. Page RC . The role of inflammatory mediators in the pathogenesis of periodontal disease. J Periodontal Res1991; 26:230-242
12. Seymour RA, Steele JG (1998). Is there a risk between periodontal disease and coronary heart disease? Br Dent J 1998; 184:33-38.
13 . Damare SM, Wells S, Offenbacher S. Eicosanoids in periodontal disease: Potential for systemic involvement. Adv Exp Med Biol 1997;433:23-35
14. Bearfield C, Davenport ES, Sivapathasundaram V, Allaker RP. Possible association between amniotic fluid micro-organism infection and microflora in the mouth. BJOG 2002;109:527-533
15. Offenbacher, S., Katz, V., Fertik, G., Collins, et al. Periodontal infection as a possible risk factor for preterm low birth weight J Periodontol 1996; 67: 1103–1113.
16. Offenbacher, S., Jared, H. L., O’Reilly, P. G.et al
Potential pathogenic mechanisms of periodontitis-associated pregnancy complications.Ann of Periodontol 1998;3: 233–250
17. Jeffcoat MK, Geurs NC, Reddy MS, et al. Current evidence regarding periodontal disease as a risk factor in preterm birth. Ann Periodontol 2001; 6:183-188.
18. Lopez NJ, Smith PC, Gutierrez J. Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomized controlled trial. J Periodontol 2002; 73:911-2412.
19 Lopez NJ, Smith PC, Gutierrez J. Higher risk of preterm birth and low birth weight in women with periodontal disease. J Dent Res 2002;81:58-63.
20. Romero, B. C., Chiquito, C. S., Elejalde, L. E.& Bernardoni, C. B. (2002) Relationship between periodontal disease in pregnant women and the nutritional condition of their newborns. J Periodontol 2002; 73:1177–1183.
21. Mitchell-Lewis D, Engebretson SP, Chen J, et al. Periodontal infections and pre-term birth: Early findings from a cohort of young minority women in NewYork. Eur J Oral Sci 2001; 109:34-39.
22. Davenport ES, Williams CEDS, Sterne JAC, Murad S, Sivapathasundram V, Curtis MA. Maternal periodontal disease and preterm low birthweight: case-control study. J Dent Res 2002; 81:313-8.
23. McGaw T. Periodontal disease and preterm delivery of low-birth-weight infants J Can Dent Assoc 2002; 68:165-9.
24. Abramowicz M, Kass EH. Pathogenesis and prognosis of prematurity. N Engl J Med 1966; 275:878-885, 938-943, 1001-1007, 1053-105917.
25 Greene JC, Vermilion JR. The Simplified Oral Hygiene Index. J Am Dent Assoc 1964; 68:7-13.
26 Carlos J, Wolfe MD, Kingman A. The extent and severity index: a simple method for use in epidemiological studies. J Clin Periodontol 1986; 13:500-505
27 Faizuddin.M, Bharathi.S.H,Rohini.N.V Estimation of interleukin-1beta levels in the gingival crevicular fluid in health and in inflammatory periodontal disease. J Periodontal Res 2003;38(2):111-4
28. Carey JC, Klebomoff MA, Hauth JC ,et al .Metranidazole to prevent preterm delivery in pregnant women with asymptomatic bacterial vaginosis, N.Engl J Med 200;24:3428:581-583
29 Pitiphat W, Joshipura KJ, Gillman MW, Williams PL, Douglass CW and Rich Edwards JW. Maternal periodontitis and adverse pregnancy outcomes. Community Dent Oral Epidemiol 2008; 36: 3–11.
30. Moore S, Ide M, Coward PY, et al. A prospective study to investigate therelationship between periodontal disease and adverse pregnancy outcome. Br Dent J 2004; 197:251-8.
31. Dasanayake AP. Poor periodontal health of the pregnant women as a risk factor for low birth weight. Ann Periodontol 1998; 3:206-212.
32, Offenbacher, S. Lieff, K.A. Boggess,et al Maternal Periodontitis and Prematurity. Part I: Obstetric Outcome of Prematurity and Growth Restriction. Annals of Periodontol 2001, Vol. 6 No. 1: 164-174
33 Louro PM, Fiori HH, Filho PL, Steibel J,Fiori RM. Periodontal disease in pregnancy and low birth weight. J Pediatr (Rio J)2001;77:23-8.
34. Boggess KA, Moss K, Madianos P, Murtha AP, Beck J,Offenbacher S. Fetal immune response to oral pathogens and risk of preterm birth. Am J Obstet Gynecol 2005;193:1121-1126.
35. Goepfert AR, Jeffcoat MK, Andrews WW, Faye-Petersen O, Cliver SP, Goldenberg RL, et al. Periodontal disease and upper genital tract inflammation in early spontaneous preterm birth. Obstet Gynecol 2004;104:777-83.
36 Mokeem SA, Molla GN, Al-Jewair TS. The prevalence and relationship between periodontal disease and pre-term low birth weight infants at King Khalid University Hospital in Riyadh,Saudi Arabia. J Contemp Dent Pract 2004; 5:40-56.
37. Jarjoura K, Devine PC, Perez-Delboy A,Herrera-Abreu M, D’Alton M, Papapanou P. Markers of periodontal infection and preterm birth Am J Obstet Gynecol 2005;192:513-9.
38. Holbrook RH, Laros RK, Creasy RK. Evaluation of a risk scoring system for prediction of pre-term labor. Am J Perinatol 1989;6:62-68.
39 Farrell S, Ide M & Wilson RF. The relationship between maternal periodontitis, adverse pregnancy outcome and miscarriage in never smokers. J Clin Periodontol 2006; 33(2): 115–120.
40. Hujoel PP, Drangsholt M, Spiekerman C, DeRouen TA (2000). Periodontal disease and coronary heart disease risk. J Am Med Assoc 2000;284:1406-1410.
41 Rajapakse PS, Nagarathne M, ChandrasekraKB, Dasanayake AP. Periodontal disease and prematurity among non-smoking Sri Lankan women. J Dent Res 2005;84:274-7
42. Khader YS, Ta’ani Q. Periodontal diseasesand the risk of preterm birth and low birth weight: a meta-analysis. J Periodontol 2005;76:161-5.
43 Xiong X, Buekens P, Fraser WD, Beck J,Offenbacher S. Periodontal disease and adverse pregnancy outcomes: a systematic review.BJOG 2006;113:135-43.
44. Michalowicz BS, Hodges JS, DiAngelis AJ, et al.Treatment of periodontal disease and the risk of preterm birth. N Engl J Med 2006;355:1885-1894.
45. Polyzos NP, Polyzos IP, Mauri D, et al. Effect of periodontal disease treatment during pregnancy on preterm birth incidence: A metaanalysis of randomized trials. Am J Obstet Gynecol 2009;200:225-232.
46. Sadatmansouri, S., Sedighpoor, N. & Aghaloo,M. (2006) Effects of periodontal treatment phase I on birth term and birth weight. Journal of Indian Society of Pedodontics and Preventive Dentistry 2006; 24, 23–26
47. Tarannum.F, Faizuddin.M . Effect of periodontal therapy on pregnancy outcome in women affected by periodontitis. J .Periodontol2007; 78:2095-2103
2. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008;371(9606):75-84.
3. Hillier SL, Krohn MA, Kiviat NB, Watts DH, Eschenbach DA. Microbiologic causes and neonatal outcomes associated withchorioamnion infection. Am J Obstet Gynecol 1991;165:955-61.4.Goldenberg RL, Rouse DJ. Medical progress: Prevention of premature birth. N Engl J Med 1998;339: 313-320[5]
5 . Hill GB. Preterm birth: associations with genital and possibly oral microflora. Ann Periodontol 1998;3:222–32.
6.Gibbs(2001) The Relationship Between Infections and Adverse Pregnancy Outcomes: An Overview Annl Periodontol 2001;6:153-163.
7. Romero R, Mazor M. Infection and preterm labor. Clin Obstet Gynecol 1988;31:553-84
8. Taylor D, Kenyon S, Tarnow-Mordi W (1997). Infection and preterm labour. Br J Obst Gynaecol 104:1338-1340.
9. Brocklehurst P . Infection and preterm delivery. Br Med J 1999; 318:548-549 10 Page RC, Kornman KS . The pathogenesis of human periodontitis. Periodontol 2000 1997 ;14:9-11.
11. Page RC . The role of inflammatory mediators in the pathogenesis of periodontal disease. J Periodontal Res1991; 26:230-242
12. Seymour RA, Steele JG (1998). Is there a risk between periodontal disease and coronary heart disease? Br Dent J 1998; 184:33-38.
13 . Damare SM, Wells S, Offenbacher S. Eicosanoids in periodontal disease: Potential for systemic involvement. Adv Exp Med Biol 1997;433:23-35
14. Bearfield C, Davenport ES, Sivapathasundaram V, Allaker RP. Possible association between amniotic fluid micro-organism infection and microflora in the mouth. BJOG 2002;109:527-533
15. Offenbacher, S., Katz, V., Fertik, G., Collins, et al. Periodontal infection as a possible risk factor for preterm low birth weight J Periodontol 1996; 67: 1103–1113.
16. Offenbacher, S., Jared, H. L., O’Reilly, P. G.et al
Potential pathogenic mechanisms of periodontitis-associated pregnancy complications.Ann of Periodontol 1998;3: 233–250
17. Jeffcoat MK, Geurs NC, Reddy MS, et al. Current evidence regarding periodontal disease as a risk factor in preterm birth. Ann Periodontol 2001; 6:183-188.
18. Lopez NJ, Smith PC, Gutierrez J. Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomized controlled trial. J Periodontol 2002; 73:911-2412.
19 Lopez NJ, Smith PC, Gutierrez J. Higher risk of preterm birth and low birth weight in women with periodontal disease. J Dent Res 2002;81:58-63.
20. Romero, B. C., Chiquito, C. S., Elejalde, L. E.& Bernardoni, C. B. (2002) Relationship between periodontal disease in pregnant women and the nutritional condition of their newborns. J Periodontol 2002; 73:1177–1183.
21. Mitchell-Lewis D, Engebretson SP, Chen J, et al. Periodontal infections and pre-term birth: Early findings from a cohort of young minority women in NewYork. Eur J Oral Sci 2001; 109:34-39.
22. Davenport ES, Williams CEDS, Sterne JAC, Murad S, Sivapathasundram V, Curtis MA. Maternal periodontal disease and preterm low birthweight: case-control study. J Dent Res 2002; 81:313-8.
23. McGaw T. Periodontal disease and preterm delivery of low-birth-weight infants J Can Dent Assoc 2002; 68:165-9.
24. Abramowicz M, Kass EH. Pathogenesis and prognosis of prematurity. N Engl J Med 1966; 275:878-885, 938-943, 1001-1007, 1053-105917.
25 Greene JC, Vermilion JR. The Simplified Oral Hygiene Index. J Am Dent Assoc 1964; 68:7-13.
26 Carlos J, Wolfe MD, Kingman A. The extent and severity index: a simple method for use in epidemiological studies. J Clin Periodontol 1986; 13:500-505
27 Faizuddin.M, Bharathi.S.H,Rohini.N.V Estimation of interleukin-1beta levels in the gingival crevicular fluid in health and in inflammatory periodontal disease. J Periodontal Res 2003;38(2):111-4
28. Carey JC, Klebomoff MA, Hauth JC ,et al .Metranidazole to prevent preterm delivery in pregnant women with asymptomatic bacterial vaginosis, N.Engl J Med 200;24:3428:581-583
29 Pitiphat W, Joshipura KJ, Gillman MW, Williams PL, Douglass CW and Rich Edwards JW. Maternal periodontitis and adverse pregnancy outcomes. Community Dent Oral Epidemiol 2008; 36: 3–11.
30. Moore S, Ide M, Coward PY, et al. A prospective study to investigate therelationship between periodontal disease and adverse pregnancy outcome. Br Dent J 2004; 197:251-8.
31. Dasanayake AP. Poor periodontal health of the pregnant women as a risk factor for low birth weight. Ann Periodontol 1998; 3:206-212.
32, Offenbacher, S. Lieff, K.A. Boggess,et al Maternal Periodontitis and Prematurity. Part I: Obstetric Outcome of Prematurity and Growth Restriction. Annals of Periodontol 2001, Vol. 6 No. 1: 164-174
33 Louro PM, Fiori HH, Filho PL, Steibel J,Fiori RM. Periodontal disease in pregnancy and low birth weight. J Pediatr (Rio J)2001;77:23-8.
34. Boggess KA, Moss K, Madianos P, Murtha AP, Beck J,Offenbacher S. Fetal immune response to oral pathogens and risk of preterm birth. Am J Obstet Gynecol 2005;193:1121-1126.
35. Goepfert AR, Jeffcoat MK, Andrews WW, Faye-Petersen O, Cliver SP, Goldenberg RL, et al. Periodontal disease and upper genital tract inflammation in early spontaneous preterm birth. Obstet Gynecol 2004;104:777-83.
36 Mokeem SA, Molla GN, Al-Jewair TS. The prevalence and relationship between periodontal disease and pre-term low birth weight infants at King Khalid University Hospital in Riyadh,Saudi Arabia. J Contemp Dent Pract 2004; 5:40-56.
37. Jarjoura K, Devine PC, Perez-Delboy A,Herrera-Abreu M, D’Alton M, Papapanou P. Markers of periodontal infection and preterm birth Am J Obstet Gynecol 2005;192:513-9.
38. Holbrook RH, Laros RK, Creasy RK. Evaluation of a risk scoring system for prediction of pre-term labor. Am J Perinatol 1989;6:62-68.
39 Farrell S, Ide M & Wilson RF. The relationship between maternal periodontitis, adverse pregnancy outcome and miscarriage in never smokers. J Clin Periodontol 2006; 33(2): 115–120.
40. Hujoel PP, Drangsholt M, Spiekerman C, DeRouen TA (2000). Periodontal disease and coronary heart disease risk. J Am Med Assoc 2000;284:1406-1410.
41 Rajapakse PS, Nagarathne M, ChandrasekraKB, Dasanayake AP. Periodontal disease and prematurity among non-smoking Sri Lankan women. J Dent Res 2005;84:274-7
42. Khader YS, Ta’ani Q. Periodontal diseasesand the risk of preterm birth and low birth weight: a meta-analysis. J Periodontol 2005;76:161-5.
43 Xiong X, Buekens P, Fraser WD, Beck J,Offenbacher S. Periodontal disease and adverse pregnancy outcomes: a systematic review.BJOG 2006;113:135-43.
44. Michalowicz BS, Hodges JS, DiAngelis AJ, et al.Treatment of periodontal disease and the risk of preterm birth. N Engl J Med 2006;355:1885-1894.
45. Polyzos NP, Polyzos IP, Mauri D, et al. Effect of periodontal disease treatment during pregnancy on preterm birth incidence: A metaanalysis of randomized trials. Am J Obstet Gynecol 2009;200:225-232.
46. Sadatmansouri, S., Sedighpoor, N. & Aghaloo,M. (2006) Effects of periodontal treatment phase I on birth term and birth weight. Journal of Indian Society of Pedodontics and Preventive Dentistry 2006; 24, 23–26
47. Tarannum.F, Faizuddin.M . Effect of periodontal therapy on pregnancy outcome in women affected by periodontitis. J .Periodontol2007; 78:2095-2103
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Published
2013-04-30
How to Cite
K, D. S., Faizuddin, D. M. F., & Basavraj, D. (2013). Maternal Periodontal Status and Risk of Adverse Pregnancy Outcomes A Case Control Study on Indian Mothers: Maternal Periodontal Status and Risk of Adverse Pregnancy Outcomes. National Journal of Integrated Research in Medicine, 4(2), 82–90. Retrieved from http://www.nicpd.ac.in/ojs-/index.php/njirm/article/view/2155
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