Periodontal infection in women with low birth weight neonates

Abstract

It has been hypothesized that in the presence of periodontal disease, periodontal pathogens are disseminated hematogenously to target the placenta,membranes, and fetus. This bacterial challenge may result in increased cytokine expression, and affect placental function and precipitate preterm labor. The present case-control study was designed to investigate whether women who delivered low birth weight neonates had a higher rate of periodontal infection. Material and Methods: A total of 150 consecutive women admitted in labor (preterm or with evidence of fetal growth restriction) with known gestational age and a first trimester ultrasound dating The control group consisted of women who had delivered a neonate of appropriate size for gestational age at term (≥37–41 weeks), matched to each case participant for age, parity, and socioeconomic status. Oral examinations were carried out within 72 hours of delivery by a periodontist blinded to the case-control status. Results: Periodontal infection was noted in 59% (177/300) of women in the study. The presence of periodontal infection was significantly higher in women with preterm (92.1%; 82/ 89 cases) and growth restricted neonates (91.8%; 56/61 cases) compared with women in the control group (26%; 39/ 150 cases) (p<0.001). All clinical parameters considered to indicate periodontal infection showed a significant association with low birth weight neonates. These parameters, whether used individually or inferred together, were indicative of periodontal infection and correlated with pregnancy outcomes. Conclusion: The findings that periodontal infection is prevalent in pregnancy and significantly higher in women who delivered low birth weight neonates suggest a need for developing preventive strategies. The clinical diagnosis of periodontal infection correlated with either inflammatory mediators or microbiological confirmation would add validity to the claims of a causal relationship.