Document Detail

Periodontitis, a marker of risk in pregnancy for preterm birth.
MedLine Citation:
PMID:  15642058     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Why chronic periodontitis may induce an inflammatory response with premature pregnancy termination is unclear. AIMS: (1) To assess if periodontitis predicts premature gestation; (2) to study amniotic fluid cytokines and periodontitis variables in early-stage pregnancy. MATERIAL AND METHODS: A periodontal examination and collection of amniotic fluid was performed (weeks 15-20) of pregnancy in 36 women at risk for pregnancy complications. Amniotic fluid (bacteria), vaginal smears and intra-oral plaque samples were studied. Cytokine levels in amniotic fluid were studied in relation to other study variables. RESULTS: Periodontitis was diagnosed in 20% of normal and in 83% of preterm birth cases (p<0.01). Bacteria were never found in the amniotic fluids studied. Sub-gingival plaque samples including bacteria in the orange and red complexes were found in 18% of full-term 100% of preterm cases (p<0.001) and total colony-forming units (CFUs) were higher in preterm birth (p<0.01). Amniotic levels of interleukin (IL)-6 and prostaglandin-E2 (PGE2) were higher in preterm cases (p<0.001). Amniotic IL-6 (r=0.56, p<0.01) and PGE2 (r=0.50, p<0.01) cytokine levels were correlated with CFU from sub-gingival plaque samples (r2=0.44). The odds ratio of preterm delivery and having periodontitis was 20.0 (95% confidence interval (CI): 2.0-201.7, p<0.01). The odds of >60 CFU in sub-gingival plaque and preterm birth was 32.5:1 (95% CI: 3.0-335.1, p<01). CONCLUSIONS: Pregnant women with findings of elevated amniotic fluid levels of PGE2, IL-6 and IL-8 in the 15-20 weeks of pregnancy and with periodontitis are at high risk for premature birth. The implication of this is that periodontitis can induce a primary host response in the chorioamnion leading to preterm birth.
Orhun Dörtbudak; Rita Eberhardt; Martin Ulm; G Rutger Persson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical periodontology     Volume:  32     ISSN:  0303-6979     ISO Abbreviation:  J. Clin. Periodontol.     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-11     Completed Date:  2005-03-31     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  0425123     Medline TA:  J Clin Periodontol     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  45-52     Citation Subset:  D; IM    
Copyright Information:
Copyright Blackwell Munksgaard, 2004.
Department of Periodontology and Fixed Prosthodontics, University of Bern, Switzerland.
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MeSH Terms
Amniotic Fluid / chemistry,  microbiology
Colony Count, Microbial
Cytokines / analysis
Dental Plaque / microbiology
Enzyme-Linked Immunosorbent Assay
Odds Ratio
Periodontal Pocket / microbiology
Periodontitis / complications*
Pregnancy Complications, Infectious* / microbiology
Premature Birth / etiology*,  microbiology
Statistics, Nonparametric
Vagina / microbiology
Vaginal Smears
Reg. No./Substance:

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