Abstract
The rate of preterm birth is a public health concern worldwide because it is increasing and efforts to prevent it have failed. We report a Clinically Relevant Complex Systematic Review (CSCSR) designed to identify and evaluate the best available evidence in support of the association between periodontal status in women and pregnancy outcome of preterm low birth weight. We hypothesize that the traditional limits of research synthesis must be expanded to incorporate a translational component. As a proof-of-concept model, we propose that this CSCSR can yield greater validity of efficacy and effectiveness through supplementing its recommendations with data of the proteomic signature of periodontal disease in pregnancy, which can contribute to addressing specifically the predictive validity for adverse outcomes. For this CRCSR, systematic reviews were identified through The National Library of MedicinePubmed, The Cochrane library, CINAHL, Google Scholar, Web of Science, and the American Dental Association web library. Independent reviewers quantified the relevance and quality of this literature with R-AMSTAR. Homogeneity and inter-rater reliability testing were supplemented with acceptable sampling analysis. Research synthesis outcomes were analyzed qualitatively toward a Bayesian inference, and converge to demonstrate a definite association between maternal periodontal disease and pregnancy outcome. This CRCSR limits heterogeneity in terms of periodontal disease, outcome measure, selection bias, uncontrolled confounders and effect modifiers. Taken together, the translational CRCSR model we propose suggests that further research is advocated to explore the fundamental mechanisms underlying this association, from a molecular and proteomic perspective.
Highlights
Periodontal disease, including gingivitis and periodontitis, is among the most common chronic disorders of infectious origin in humans
This study is aimed at utilizing the research synthesis design to provide a clinically relevant complex systematic review (CRCSR) of the best available evidence on the association between periodontal status in women and pregnancy outcome preterm low birth weight
We propose a hypothesis about how the clinical relevance of the CRCSR findings may be broadened by a translational arm addressing the proteomic signature of periodontal disease in pregnancy, in order to yield novel understanding of the predictive variables for adverse pregnancy outcomes
Summary
Periodontal disease, including gingivitis and periodontitis, is among the most common chronic disorders of infectious origin in humans. Periodontal disease is associated with certain systemic conditions as increased risk of cardiovascular and cerebrovascular diseases, including atherosclerosis and diabetes [1]. Cardiovascular disease has complex determining factors, including genetics and gender, but evidence shows that chronic periodontal infection is detrimental to the cardiovascular system. One is that chronic infection of the mouth may lead to thromboembolic disease (blood clotting) via bacterial protein interfering with platelet aggregation [2]. Another possibility is that bacteria from the mouth enter the bloodstream and trigger the production of pro-inflammatory cytokines, which are responsible for promoting inflammation and over time lead to pathology of the cardiovascular system.. Another possibility is that bacteria from the mouth enter the bloodstream and trigger the production of pro-inflammatory cytokines, which are responsible for promoting inflammation and over time lead to pathology of the cardiovascular system. Respiratory infections have been linked to periodontitis [1]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
