Periodontal Disease and Vitamin D Deficiency in Pregnant Women: Which Correlation with Preterm and Low-Weight Birth?

Martina Ferrillo,Giuseppina Rosaria Umano,Pier Luigi Foglio Bonda,Dario Calafiore,Andrea Roccuzzo,Mario Migliario,Giovanni Falcicchio,Pedro Molinero-Mourelle,Alessandro de Sire,Federica Pezzotti

doi:10.3390/jcm10194578

Abstract

Periodontal disease seems to be correlated with low vitamin D serum levels, preterm birth (PTB) and low birth weight (LBW), although the literature still lacks a consensus. This study aimed to investigate this correlation in a cohort of pregnant women over 20 weeks of gestation from the University Hospital “Maggiore della Carità”, Novara, Italy. We assessed serum levels of vitamin D and oral health status through the following indexes: Oral Hygiene Index (OHI), Plaque Control Record (PCR), Gingival Bleeding Index (GBI), and Community Periodontal Index of Treatment Needs (CPTIN). Moreover, we assessed the number of PTB and LBW among the newborns. Out of 121 pregnant women recruited, 72 (mean age 29.91 ± 3.64 years) were included. There was a statistically significant correlation between preterm and OHI > 3 (p = 0.033), and between LBW and OHI > 3 (p = 0.005) and CPITN = 3 (p = 0.027). Both pregnant women with vitamin D deficiency ((25-hydroxy-vitamin D) < 30 ng/mL) and PTB plus LBW newborns were significantly correlated (p < 0.05) with poor levels of all oral health status indexes during pregnancy. Furthermore, these conditions (women with hypovitaminosis D and combination of PTB and LBW) were shown to be significantly correlated (p < 0.001). Taken together, our findings reported a high prevalence of PTB and LBW with poor oral health and vitamin D deficiency in pregnant women.

Highlights

Periodontal disease is one of the more common inflammatory diseases in the adult population, with an incidence varying from 5 to 30% [1,2,3,4]
Considering the combination of preterm birth (PTB) and low birth weight (LBW), we found a significant correlation with Oral Hygiene Index (OHI)>3 (p = 0.001), Plaque Control Record (PCR)>75% (p = 0.035), Gingival Bleeding Index (GBI)≥50% and
Women with hypovitaminosis D have a significant correlation with the combination of PTB and LBW (p < 0.001)

Summary

Introduction

Periodontal disease is one of the more common inflammatory diseases in the adult population, with an incidence varying from 5 to 30% [1,2,3,4]. Periodontal disease produces inflammatory mediators and microbial products that can enter the systemic circulation through the mouth and reach distant organs [8,9]. Vitamin D might affect periodontal disease both through an effect on bone mineral density and through immunomodulatory effects [23,24,25]. The effects of low vitamin D levels on periodontal health represent a matter of interest. Over the past few decades, vitamin D deficiency has been associated with gingivitis and periodontitis of different severities [26,27,28]. Studies demonstrated that vitamin D might decrease the number of Porphyromonas gingivalis (Pg) through active autophagy [29], and the inflammatory burden of periodontitis in rodent models [30,31]

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