Abstract
BackgroundPeriodontal disease has been associated with gestational complications and both conditions have a high prevalence in rural populations from developing regions. A cross-sectional study was carried out to explore the relationship between periodontal inflamed surface area (PISA), blood pressure (BP), and, serum uric acid levels (UA) in a group of rural North Chinese pregnant women in the third trimester of pregnancy.MethodsThree hundred and thirty-five rural women aged 20–34 years, with normal body mass index (BMI) were examined in a cross-sectional study during their third trimester of gestation. Exclusion criteria were history of pregnancy complications, multiple pregnancy, smoking habits, diabetes, hypertension or any known infectious disease. Socio-demographic variables, including age and socioeconomic status (SES), systolic blood pressure (SBP) and diastolic blood pressure (DBP) readings, serum UA levels, and PISA values were recorded. A structural equation model was implemented with two constructed latent variables including “Dem” (comprising of age and SES category to represent unobserved demographic variables) and, “BP” (comprising of SBP and DBP to account for measurement error and lack of multiple BP readings). The model accounted for co-variance of BP and UA, and implemented simultaneous regressions for BP and UA as outcomes, upon Dem and PISA values as exogenous variables.ResultsThe median PISA score was 1,081.7 (IQR = 835.01), reflecting high levels of periodontal inflammation in the sample. SEM showed a significant association of PISA with BP (estimate = 0.011, 95% CI = 0.009–0.012 p < 0.001) and UA (estimate = 0.001, 95% CI = 0.001–0.001, p < 0.001).ConclusionHigher PISA values were significantly associated with higher blood pressure and uric acid levels among rural pregnant women in a cross-sectional sample from a center in North China after accounting for a latent demographic construct derived from age and SES.
Highlights
Hypertensive disorders of pregnancy affect more than 5% of women in China, with the highest incidence in North China [1]
periodontal inflamed surface area (PISA) score was moderately correlated with DBP (r = 0.58, p < 0.001) and strongly correlated with SBP (r = 0.66, p < 0.001) and uric acid levels (UA) (r = 0.72, p < 0.001)
The latent variable blood pressure (BP) was highly significantly predicted by PISA and significantly predicted by Dem
Summary
Hypertensive disorders of pregnancy affect more than 5% of women in China, with the highest incidence in North China [1]. Inflammation has been implicated in the pathogenesis of preeclampsia and attributed to chronic subclinical infections and higher levels of pro-inflammatory cytokines [3]. Gestational blood pressure and increased oxidative stress are interlinked [4] and both are associated with a higher risk of adverse pregnancy outcomes [5]. A primary physiological antioxidant is considered as one of the primary markers of oxidative stress [7] and hyperuricemia in pregnancy is implicated both as a risk marker and contributory factor for preeclampsia [8]. Increased blood pressure during the third trimester of pregnancy is linked to adverse birth outcomes [9]. A cross-sectional study was carried out to explore the relationship between periodontal inflamed surface area (PISA), blood pressure (BP), and, serum uric acid levels (UA) in a group of rural North Chinese pregnant women in the third trimester of pregnancy
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