Abstract
Infections may play a significant role in the induction of births and prematurity. Periodontal disease could be a risk factor for pregnancy outcomes such as preterm birth, and low birth weight. Possible mechanisms of this relationship are the production of inflammatory mediators and cytokines like C-reactive protein (CRP), prostaglandin E2 (PGE2), matrix metalloproteinases, interleukin 1 (IL-1), IL-6, and tumor necrosis factor alfa (TNF-a); the translocation of periodontal pathogens to the feto-placental unit through blood stream, a periodontal reservoir of lipopolysaccharides (LPS); and shared risk factors. Although this knowledge is just emerging, it has important implications for the health services and the healthcare delivery model. Committed health teams to an interprofessional collaborative work within the health services can raise the quality of antenatal care. Population strategies directed to prevent and control periodontal disease can increase the periodontal health of the majority of people and affect positively risk groups. These inexpensive basic measures joined with other actions at different levels could enhance the quality of antenatal care and contribute for favorable pregnancy outcomes. Further researches need to clarify the evidences on those relationships.
Highlights
Preterm birth is defined as babies born alive before 37 weeks of pregnancy are completed
Periodontal disease could be a risk factor for pregnancy outcomes such as preterm birth, and low birth weight. Possible mechanisms of this relationship are the production of inflammatory mediators and cytokines like C-reactive protein (CRP), prostaglandin E2 (PGE2), matrix metalloproteinases, interleukin 1 (IL-1), IL-6, and tumor necrosis factor alfa (TNF-a); the translocation of periodontal pathogens to the feto-placental unit through blood stream, a periodontal reservoir of lipopolysaccharides (LPS); and shared risk factors
Available data show that maternal periodontitis is modestly but significantly associated with preterm birth, low birth weight and preeclampsia
Summary
Preterm birth is defined as babies born alive before 37 weeks of pregnancy are completed. Risk factors for preterm birth and low birth weight include maternal age (34 years), higher rates of teenage pregnancy, chronic maternal malnutrition, low weight gain in pregnancy, low maternal height, low pre-pregnancy body-mass index, African American ancestry, low socioeconomic status, multiple pregnancies, smoking, alcohol, drug abuse Chronic conditions such as diabetes and high blood pressure have been considered a risk factor for preterm birth (Katz et al, 2013; Kawar & Alrayyes, 2011). Infections in other parts of the body may play an important role in the induction of births and prematurity by favoring an immune response joined to the transit of microorganisms and/or their toxins in the bloodstream to the maternal–fetal unit (Uppal et al, 2010) In this matter, many adverse pregnancy outcomes such as pre-term delivery and preterm low birth weight infants may be associated to the infected periodontal tissues (Offenbacher et al, 2001)
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