Abstract
ABSTRACTIn this observational and prospective study, we investigated if microbiological and serological markers of periodontitis associated with conception in 256 non-pregnant women (Mage = 29.2 years; range 19–42 years). Clinical oral and gynecological examinations were performed, major periodontal pathogens in the saliva were detected, and serum and saliva antibodies against major periodontal pathogens were analyzed. The follow-up period for becoming pregnant was 12 months. Porphyromonas gingivalis was significantly (p = 0.032) more frequently detected in the saliva among those who did not become pregnant (8.3%) than among those who became pregnant (2.1%). The median levels of salivary P. gingivalis immunoglobulin A (IgA; p = 0.006) and IgG (p = 0.007) antibodies were higher among those who did not become pregnant compared to those who became pregnant. Hazard ratios (HR) for not becoming pregnant were HR = 3.75 (95% confidence interval [CI] 1.01–13.9; p = 0.048) if the subject was polymerase chain reaction–positive for P. gingivalis with high salivary antibodies against it, and HR = 1.62 (95% CI 1.03–2.54; p = 0.035) if she had high levels of serum P. gingivalis IgA and signs of periodontal infection. P. gingivalis associated with no success in getting pregnant.
Highlights
All antibody levels measured from saliva and serum were higher among those with clinical PAL, and these differences were statistically significant for saliva (p = 0.001) and serum (p = 0.042) A. actinomycetemcomitans immunoglobululin G (IgG), as well as saliva P. gingivalis immunoglobulin A (IgA) (p = 0.025) and IgG (p < 0.001)
For A. actinomycetemcomitans, the differences were significant for serum IgA (p = 0.009), serum IgG (p = 0.006), and saliva IgG (p < 0.001)
The main finding was that the detection of P. gingivalis in saliva and elevated concentrations of salivary antibodies against this periodontal species significantly increase the risk for unsuccessful conception among young women
Summary
Periodontal infection has been linked to several medical conditions such as cardiovascular diseases, diabetes, respiratory infections, and adverse pregnancy outcomes, including premature birth and low birth weight [2,3]. This systemic connection may be mediated by bacterial lipopolysaccharide (LPS), resulting in endotoxemia and a subsequent low-grade pro-inflammatory state [4]. Gram-negative bacteria, such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, that are enriched in the biofilm of periodontal infection may contribute to endotoxemia [5,6] and contribute to systemic inflammation. These species may give rise to molecular mimicry, that is, cross-activation of autoreactive immune cells by pathogen-associated epitopes, which have harmful implications [7,8]
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