Periodontal Disease In Pregnant Women Research Articles

Comparative Evaluation and Correlation of Periodontal Status With Inflammatory Markers in Pregnant Women With or Without Chronic Periodontitis: A Clinico-Hematological Study.

Background The research delves into the intricate relationship between periodontal health and specific blood biomarkers in pregnant women during their second trimester. It specifically focuses on the levels of interleukin-6 (IL-6), lactate dehydrogenase (LDH), and C-reactive protein (CRP) in those suffering from chronic periodontitis compared to healthy controls. Methodology A detailed approach was taken involving 60 pregnant women categorized into two groups based on the presence or absence of chronic periodontitis. Out of 60 pregnant women, 30 had chronic periodontitis, while the other 30 served as controls selected from the regular patient population of the college. The study utilized blood sample analysis and advanced statistical tools for data analysis, ensuring precise and reliable results. Levels of IL-6, LDH, and CRP in those suffering from chronic periodontitis compared to healthy controls were checked. Results The findings revealed a notable variance in IL-6, LDH, and CRP levels between the two groups. Women with chronic periodontitis exhibited significantly higher levels of these biomarkers. The statistical analysis reinforced the validity of these differences, highlighting their significance. Conclusions The study underscored a clear link between higher levels of IL-6, LDH, and CRP and the presence of chronic periodontitis in pregnant women. These biomarkers emerge as potential indicators for early detection and monitoring of periodontal health in this demographic.

Evaluation of association between periodontitis in pregnant women and preeclampsia

Abstract Background and Objective: Preeclampsia is a maternal disease encountered during the second half of pregnancy. Many risk factors have been implicated in its pathogenesis. Periodontitis may burden pregnant patients systemically with cytokines and endotoxin at the maternal fetal interface leading to endothelium dysfunction. Hence, our objective was to check the association between periodontitis and preeclampsia. Materials and Methods: This observational study was conducted in the outpatient department (OPD) of community health center from March 15, 2022, to December 14, 2022, on 100 patients. Inclusion Criteria: Pregnant women of age group >18 years with informed consent with gestational age between 26 and 36 weeks with Singleton pregnancy. Women with a history of smoking, alcohol and periodontal treatment, multiple pregnancy, and consumption of antibiotics (3 months before study inclusion) were excluded. All eligible candidates in the antenatal clinic in OPD of obstetrics and gynecology were screened by history, obstetrical examination, routine antenatal tests, including urine routine and blood pressure measurement. Subjects were evaluated as per the designed protocol. Fifty preeclamptics were taken as case and 50 non preeclamptic were taken as control. Oral examination was conducted on the patients at the inclusion in the study and followed till delivery. Blood pressure and urine albumin were checked at each visit. Details noted on delivery and outcomes were observed. Results: The risk of preeclampsia in women having periodontitis showed an odds ratio of 3.436 (95% confidence interval: 1.460–8.065; P = 0.006). Conclusion: As the etiology of both events is multifactorial preeclampsia and periodontitis relationship needs wise attention.

Prevalence and social determinants of periodontal disease in Colombian pregnant women.

The objective of the study was to identify the prevalence of periodontal disease in pregnant women in the Colombian population and its association with social determinants and medical history based on data from the Fourth National Oral Health Survey (ENSAB IV). A total of 1012 pregnant women from different areas of Colombia were evaluated. A periodontal evaluation was performed using a North Carolina periodontal probe. The following data were recorded: number of teeth, probing depth (PD), the position of the gingival margin (GM) and clinical attachment level (CAL). An ordinal logistic regression analysis was performed for the association between social determinants and the Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP) classification and logistic regression between social determinants and the European Federation of Periodontology (EFP) classification. The prevalence of periodontitis was 37.1% using the CDC/AAP criteria and 41.2% according to the criteria of EFP distributed in sensitive (40.2%) and specific cases (0.9%). Age, belonging to a subsidized regime, living in a rural area, having an intermittent water supply and bleeding in medical records were found to be positively associated with periodontitis (mild, moderate, severe). The findings of this national study of pregnant women show a high prevalence of periodontitis-using the CDC/AAP and EFP criteria-associated with age, living in rural areas, subsidized regime, intermittent water supply and bleeding in medical records.

Knowledge Level of Women’s Reproductive Age Regarding Oral Health During Pregnancy

Introduction: A woman will generally experience pregnancy, which can change the health of her oral cavity. Changes that occur in gingiva are often increasing estrogen and progesterone hormones, which are combined with alteration in oral flora and decreased immune response. This occurrence can lead to gingivitis and periodontitis during pregnancy if oral hygiene is inadequate. Periodontal disease in pregnant women is associated with premature birth, low birth weight, and preeclampsia. Objective: To determine the level of women of childbearing age regarding oral health during pregnancy at the Makassar District Health Center, East Jakarta. Research Methods: This type of research is analytic with a cross-sectional research design. The number of respondents in this study was 101 respondents using a purposive sampling method. Data collection was carried out through questionnaires and data were analyzed using the Chi-Square proportion test. Results: The results of the Chi-Square test between the level of knowledge of women of childbearing age regarding oral health during pregnancy based on age, occupation, and marital status showed insignificant results (p>0.05) while the results of the Chi-Square test based on education level, SES, and history of pregnancy showed significant results (p<0.05). Conclusion: Most women of childbearing age, who visit the Makassar sub-district health center, East Jakarta, have low knowledge about oral health during pregnancy. The knowledge of women of childbearing age at the Makassar district health center, East Jakarta, is related to their education background, SES, and history of pregnancy.

Relationship between periodontal disease in pregnant women and premature birth: a comprehensive review

Initially, it should be noted that the birth of premature babies constitutes the fundamental cause of morbidity and mortality and morbidity soon after birth. There are several factors that imply risks and are directly related to its development, such as the use of psychoactive substances, infections of the genito-urinary tract and tobacco. smoke and other infections at a distance. Periodontal disease is considered an independent risk factor for premature low birth weight babies, which places active periodontal disease as an independent risk factor for the birth of premature and low birth weight babies. In this perspective, the objective of this work is to analyze periodontal disease as a risk factor for prematurely born babies. The methodology used in the development of the work is the literature review, with the use of articles from reference periodicals for the theme. It can be stated that in cases of periodontal disease, inflammatory stimuli can induce hyperirritability of the uterine smooth muscle, causing contraction of the uterus and cervical dilation, triggering premature birth. By constituting a chronic infection, it can influence the occurrence of premature birth indirectly or directly. However, it is important to understand that the treatment of periodontal disease is effective, reducing the incidence of premature birth.

Health Profile of Periodontal Tissue of Pregnant Women in The Agromedical Dental Community in Jember District

Background: Periodontal disease is a disease found worldwide and the prevalence of periodontal disease is around 75% in Jember Regency in pregnant women. Periodontal disease during pregnancy is a risk factor for low birth weight. Therefore, it is crucial to study the ways of maintaining oral hygiene in pregnant women to prevent periodontal disease in pregnant women. The aim of this study was to determine the health profile of the periodontal tissue of pregnant women in the dental agromedical community in the Jember Regency. Methods: This research is a descriptive observational survey-based study. The study population was pregnant women(n=50) in the 1st-3rd trimester, aged 20-30 years, and were having a pregnancy checkup at the MCH polyclinic of the Integrated Service Post in the Coastal area (Puger area) and the Plantation area (Renteng area). Gingival status was examined using the Gingival Index (GI), periodontal health status using the Community Periodontal Index of Treatment Need (CPITN), and oral hygiene status using the Oral Hygiene Index-Simplified (OHI-S). Results: The research results showed that the average CPITN was 2.20 in the plantation area and 2.12 in the coastal area which showed the presence of calculus and no presence of pockets. A score of 3 indicates that the gingiva has a sulcus depth of 4-5 mm and in this case, there was no presence of a pocket but edema in the gingiva was found. Conclusion: This study concluded that pregnant women in the coastal area had mild gingivitis and calculus with no presence of pockets in the plantation area.

Periodontitis in Pregnant Women: A Possible Link to Adverse Pregnancy Outcomes.

Periodontitis develops in 11% of pregnant women, and it is independently linked to severe complications during pregnancy such as preterm birth, low birth weight, and gestational diabetes. A literature search (Pubmed/MEDLINE, and Scopus) from 2003 to 2023 was conducted to analyze studies focused on periodontitis and adverse pregnancy outcomes. 16 articles have been included. Most of the studies showed adverse outcomes, like preterm birth and the low weight of the unborn child, are among the most frequent consequences (respectively 62.5% and 68.7% of articles); pre-eclampsia is also linked to this condition (12.5% of articles); and perinatal mortality (12.5% of articles). Periodontal disease appears to be associated with adverse events in pregnancy due to the transport of biofilm bacteria into the bloodstream and into placental tissue; what would cause adverse events is the body's immune response to infection.

Pathophysiological Mechanisms of Periodontitis in Pregnant Women with Metabolic Syndrome Leading to Adverse Pregnancy Outcomes

Pathophysiological Mechanisms of Periodontitis in Pregnant Women with Metabolic Syndrome Leading to Adverse Pregnancy Outcomes

Association between the Risk of Preterm Birth and Low Birth Weight with Periodontal Disease in Pregnant Women: An Umbrella Review.

The purpose of this review is to determine the association between the risk of preterm birth and low birth weight in newborns and periodontal disease in pregnant women. A bibliographic search was carried out until November 2021 in the following biomedical databases: PubMed/Medline, Cochrane Library, Scopus, EMBASE, Web of Science, Scielo, LILACS and Google Scholar. Studies reporting the association between the risk of preterm birth and low birth weight in newborns with periodontal disease in pregnant women, which were systematic reviews, in English and without time limits were included. AMSTAR-2 was used to assess the risk of the included studies, and the GRADEPro GDT tool was used to assess the quality of the evidence and the strength of the recommendation of the results. The preliminary search yielded a total of 161 articles, discarding those that did not meet the selection criteria, leaving only 15 articles. Seven articles were entered into a meta-analysis, and it was found that there is an association between the risk of preterm birth and low birth weight in newborns with periodontal disease in pregnant women. There is an association between the risk of preterm birth and low birth weight in newborns with periodontal disease in pregnant women.

Relationship between soluble neuropilin-1 in the gingival crevicular fluid of early pregnant women and different severities of periodontitis: A cross-sectional study.

Pregnancy exacerbates the periodontal inflammation; however, the biological mediators involved are not well characterized. Neuropilins (NRPs) are transmembrane glycoproteins involved in physiological and pathogenic processes such as angiogenesis and immunity but its relationship with periodontal disease in pregnant women has not been studied. To explore the soluble Neuropilin-1 (sNRP-1) levels in gingival crevicular fluid (GCF) samples during early pregnancy and its association with the periodontitis severity and periodontal clinical parameters. 80 pregnant women were recruited, and GCF samples were collected. Clinical data and periodontal clinical parameters were recorded. sNRP-1 expression was determined by ELISA assay. The relationship between sNRP-1(+) pregnant women with the severity of periodontitis and periodontal clinical parameters was determined by Kruskal-Wallis and Mann-Whitney tests. Spearman's test estimated the correlation between sNRP-1 levels and periodontal clinical parameters. Periodontitis was classified as mild in 27.5% (n=22) women, moderate in 42.5% (n=34), and severe in 30% (n=24). sNRP-1 expression was higher in the GCF of pregnant with severe (41.67%) and moderate (41.17%) periodontitis compared than in those with mild periodontitis (18.8%). The sNRP-1(+) pregnant had a higher BOP (76.5% v/s 57%; p=0.0071) and PISA (1199.5 mm2 v/s 880.2 mm2; p=0.0282) compared with sNRP-1(-). A positive correlation between sNRP-1 levels in GCF and BOP (p=0.0081) and PISA (p=0.0398) was observed. The results suggest that sNRP-1 could be involved in periodontal inflammation during pregnancy.

ETIOLOGICAL FACTORS IN DISEASES OF HARD TISSUES AND PERIODONTIUM IN PREGNANT WOMEN

Pregnant women have one of the highest risks of dental disease [3]. According to a number of authors, during the physiological course of pregnancy, the prevalence of dental caries is 91.4%, periodontal tissue diseases occur in 90% of cases, lesions of previously intact teeth with a predominantly acute course of the carious process - in 38% of pregnant patients [5 ]. Secondary caries, progression of the carious process, enamel hyperesthesia occurs in 79% of pregnant women [11]. At the same time, the intensity of the increase in dental caries in terms of the absolute increase in the index of caries-filling-removal during the gestational period is 0.83 [2]. In 50% of pregnant women and women in labor, the so-called gingivitis of pregnant women is observed during the normal course of the gestational period already at 2-3 months of pregnancy [12]. From the second half of pregnancy, the pathological process becomes more pronounced and more often proceeds as a generalized catarrhal or hypertrophic gingivitis, and pyogenic granuloma often develops. As pregnancy progresses, periodontal disease progresses continuously, and only in the postpartum period does the clinical picture improve [4]. In the long term, gingivitis that occurs during pregnancy becomes chronic [9, 10]. In a pregnant woman, against the background of altered reactivity and reduced body resistance, latent odontogenic foci of infection can lead to serious complications as a result of exacerbation of the inflammatory process [7, 8]. The greatest severity of inflammatory phenomena in periodontal tissues occurs in the second trimester of pregnancy, and the critical increase in the cariogenic situation in the oral cavity occurs in the third trimester [4, 2], which not only determines the optimal timing of dental examinations during pregnancy and the postpartum period, but also the differentiation of the approach to programs for the prevention and treatment of the most significant diseases of the oral cavity for this period of pregnancy. The decisive role in the development of caries and periodontitis in pregnant women belongs to hormonal substances (somatomammotropin, progesterone, gonadotropin) produced by the placenta, changes in mineral and protein metabolism, immunological status, oral microflora [1, 5]. The timing of the increased risk of the onset and progression of periodontal diseases, as well as the increase in the intensity of dental caries in pregnant women, is not enough to state; tires. This does not negate the significance of already established factors affecting the occurrence and development of dental caries, periodontal disease during pregnancy, but is aimed at competently combining diagnostically important known and newly identified criteria into a system of practical recommendations for identifying risk groups among pregnant women. on dental health and special monitoring of them. Immunoprotective peptides of biological media, including oral fluid, are markers of the intensity of local inflammation and are responsible for the implementation of innate antimicrobial immunity [6, 12]. In the oral fluid, a whole complex of immunoprotective peptides is isolated, among which lactoferrin, cathelicidin LL-37, and α-defensin are distinguished [14]. The inclusion of immunoprotective peptides in algorithms and models for ranking the risk of progression of dental caries during pregnancy will expand the boundaries of existing recommendations in this direction. When studying systemic immunity in pregnant women with periodontal diseases, oral fluid and peripheral blood are used as biological media [8]. At the same time, retroplacental blood and umbilical cord blood containing fetal and maternal blood, despite the easy method of selection after the birth of a child and placenta, not associated with invasive manipulations, is not used as a biological medium. Meanwhile, the determination of the spectrum of inflammatory mediators, the mineral composition of retroplacental and umbilical cord blood will allow answering the questions whether inflammation of the periodontal tissues of varying severity was accompanied by the "mother-placenta-fetus" system, whether it is possible to predict from the stage of childbirth in the future the appearance of caries of milk teeth? The purpose of this study is to optimize the system of providing dental care to pregnant women using clinical and laboratory indicators.

The Potential Association Between Periodontal Diseases and Adverse Pregnancy Outcomes in Pregnant Women: A Systematic Review of Randomized Clinical Trials.

Preceding studies have demonstrated that periodontitis might increase the liability of adverse pregnancy outcomes such as preterm birth, preeclampsia, low birth weight, and perinatal fatality in pregnant women. Nonetheless, there is no convincing testimony that periodontitis is related directly to adverse pregnancy outcomes in pregnant women. This systematic review intended to assess and review all the available randomized clinical trials that concentrated on the association between periodontal diseases and adverse pregnancy outcomes, and the impact of periodontal disease therapy on adverse pregnancy outcomes. The databases like Scopus, PubMed, Google Scholar, and Web of Sciencewere consumed to explore relevant and suitable studies after adopting the inclusion and exclusion criteria. The search included articles with no time restrictions and certain keywords were utilized in the databases. The investigation was done through four independent reviewers employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twenty-three studies fulfilled the exclusion and inclusion criteria and were used and included in this systematic review. The above-mentioned studies assessed the association between periodontal diseases and adverse pregnancy outcomesand the effect of periodontal disease treatment in reducing the influence of adverse pregnancy outcomes. This systematic review revealed that there is a relationship between periodontitis and adverse pregnancy outcomes, and periodontal treatment has a reducing impact on adverse pregnancy outcomes in pregnant women with periodontitis. Prospect studies are warranted to investigate the relationship between periodontitis and different adverse pregnancy outcomes and to decide the best type and the most effective therapy to treat periodontitis in pregnant women.

Relationship Between the Periodontal Status of Pregnant Women and the Incidence and Severity of Pre-term and/or Low Birth Weight Deliveries: A Retrospective Observational Case-Control Study.

Literature worldwide has linked periodontitis to preterm births and/or low-birth-weight infants. However, to our knowledge, research on this topic is scarce in India. The United Nations Children's Fund (UNICEF) reports that South Asian nations, particularly India, have the highest rates of preterm births and low-birth-weight infants as well as periodontitis due to poor socioeconomic conditions. Overall, 70% of perinatal fatalities result from prematurity and/or low birth weight, which also increases the incidence of morbidity and drives up the cost of postpartum care by a factor of ten. The frequency and severity of the illness may be greater among the Indian population due to their poor socioeconomic status. To lower the mortality rate and the cost of postnatal care, it is necessary to investigate the impact and severity of the effect of periodontal conditions on pregnancy outcomes in India. Following the collection of obstetric and prenatal records from the hospital in compliance with inclusion and exclusion criteria, a sample of 150 pregnant women were chosen from public healthcare clinics for the research. Within three days of delivery following enrolment in the trial, a single physician recorded each subject's periodontal condition using the University of North Carolina-15 (UNC-15) probe under artificial lighting and the Russell periodontal index. The gestational age was calculated based on the latest menstrual cycle, and a medical professional would order an ultrasound if they felt it was essential. The doctor weighed the newborns soon after delivery and in accordance with this prenatal record. The acquired data was analyzed using a suitable statistical analysis technique. The severity of a pregnant woman's periodontal disease was significantly correlated with the infant's birth weight and gestational age. Preterm births and low-birth-weight infants became more prevalent as the severity of the periodontal disease rose. The results demonstrated that periodontal disease in pregnant women may increase the risk of preterm delivery and low birth weight in infants.

Label-Free Quantitative Proteomic Analysis Reveals Inflammatory Pattern Associated with Obesity and Periodontitis in Pregnant Women

Obesity and pregnancy may have synergistic effects on periodontal condition, and proteomics could be an ideal approach to highlight the pathophysiological mechanisms associated with these outcomes. This study analyzed the salivary proteomics related to obesity and periodontitis in women during pregnancy (T1) and after delivery (T2). Initially, 126 women were recruited and forty were allocated into groups: with obesity and periodontitis (OP); with obesity, but without periodontitis (OWP); with normal BMI, but with periodontitis (NP); with normal BMI and without periodontitis (NWP). Whole-mouth saliva was collected in T1 and T2, and proteins were extracted and individually processed by label-free proteomics (nLC-ESI-MS/MS). The up-regulations of Heat shock 70 kDa protein 1A, 1B, and 1-like were related to both obesity and periodontitis, separately. Albumin and Thioredoxin were up-regulated in periodontitis cases, while Cystatins (mainly S, SA, SN) and Lactotransferrin were down-regulated. The high abundances of Submaxillary gland androgen-regulated protein 3B, Protein S100-A8, Matrix metalloproteinase-9, Heat shock 70 kDa protein 2 and 6, Putative Heat shock 70 kDa protein 7, Heat shock 71 kDa protein, Haptoglobin and Plastin-1 were significant in the combination of obesity and periodontitis. Obesity and periodontitis remarkably altered the proteome of the saliva during pregnancy with substantial alterations after delivery.

Assessment of the Community Periodontal Index of Treatment Needs (CPITN) in Pregnant Women Referring to the Health Centers in Arak, Iran

Objectives: The periodontal disease during pregnancy is considered to be significant because not only does it affect the tissues supporting the teeth, but also it is connected with systemic conditions such as adverse pregnancy outcomes. The present study aimed at assessing periodontal disease in pregnant women and other relevant demographic factors. Materials and methods: This is a cross-sectional, descriptive-analytical study that was conducted among 275 pregnant women visiting the health centers in Arak, Iran, in 2021. Cluster random sampling method was used to select the samples. The demographic information was gathered and periodontal statues was examined using the Community Periodontal Index of Treatment Needs (CPITN). The data were analyzed by SPSS18 software, using logistic regression. Results: According to the results, 55.4% of the pregnant women had periodontal disease (CPI>0). Bleeding on probing (BOP), dental calculus, and periodontal pocket depth (PPD) between 4 and 5 mm were observed of 17.5%, 36.4%, 5.1% of women, respectively. No periodontal pocket deeper than 6mm was observed. Brushing frequency was the main predictor for gingival health, and the women with under diploma education (OR: 2.26, 95% CI: 1.14-4.48) and having one or more children were (OR: 1.40, 95% CI: 1.02-1.94) more likely to have periodontal disease than women with academic education or having no children. Conclusion: According to the findings, pregnant women were not in good health condition in terms of periodontal disease. Considering the demographic and behavioral differences, designing the health promotion programs during pregnancy is recommended.

Assessment of the Association of Periodontal Diseases in Pregnant Women and the Efficacy of Periodontal Treatment in the Context of Premature Births and Pregnancy Complications - a Narrative Review.

Introduction Periodontal diseases are widespread in women of reproductive potential. Although their treatment of these disorders contributes to oral health, there is still no conclusive evidence that this intervention has a beneficial effect on the course of pregnancy, in particular the rate of premature births. On the one hand, the aim of the paper is a systematic assessment of the association between periodontal diseases and pregnancy complications, based on the current literature. On the other hand, the efficacy of periodontal treatments vs. no treatment in pregnant women should be assessed with the target criterion of premature birth or other pregnancy complications. Materials and methods The narrative review was based on the PRISMA statement. Premature births were defined as primary endpoints, while various perinatal and maternal outcomes were grouped together as secondary endpoints. An electronic database search for relevant meta-analyses and systematic reviews was carried out in PubMed and the Cochrane database. Methodological characteristics and the results of the included studies were extracted. The RR or OR (95% CI) was used to measure the result. The quality of the included studies was assessed according to the AMSTAR checklist. Results Seven publications were included (total number of subjects n = 56755). The majority of included studies do not demonstrate a significant association of periodontal disease and/or periodontal treatment with certain childhood and/or maternal outcomes. The quality of the included studies was deemed to be sufficient. Conclusion Even today, there is insufficient evidence to confirm the correlation between periodontal disease and certain maternal and/or infantile outcomes. Periodontal treatment during pregnancy also does not seem to affect the risks of pregnancy. Nevertheless, it is recommended that all pregnant women are advised to improve their daily oral hygiene in order to prevent inflammatory diseases, regardless of the progress of the pregnancy.

Prevalence of periodontal disease in pregnant patients: a systematic review

Introduction: The stage of pregnancy involves different physiological variations that globally alter hormones, making a person's body the appropriate place for infections such as periodontal disease to develop. The objective of this study was to establish the prevalence relationship between periodontal disease and pregnant patients. Methods: articles not older than 5 years were examined, taking studies between 2017 and 2021, extracted from the main Pubmed, Science Direct, SCOPUS, Proquest and EBSCO databases, as well as for the development of the systematic review, the guidelines were followed. of PRISM. Results: For this work, different perspectives of both exclusion and inclusion were applied, for which several filters were passed, leaving 7 articles selected (n=1178). The different data found were passed through a process of extraction and subsequent ordering, following the standards of the study, as an analysis methodology, as well as the results. Conclusion: As a result, it was obtained that the prevalence of periodontitis in pregnant women is high, since in all the studies included in this investigation, percentages between 50% and 70% of prevalence in pregnant women were evidenced, this being a risk factor. This is important for pregnancy complications, as the newborn may show low birth weight or the mother a premature delivery, in addition to the physiological factors of a pregnant woman compromising the immune system, leaving her more prone to suffering this type of dental pathology.

Periodontal diseases in pregnant women as a risk factor: a concise systematic review

This study highlighted that periodontal diseases in pregnant women can be one of the determinants of low birth weight. Studies were carried out to verify the existence of an association between maternal periodontal disease and low birth weight. Gestational period, where the occurrence of periodontal diseases (PD) is more likely, due to its hormonal and physiological changes. Therefore, pregnant women must be alert and take proper care, have prenatal care with their dentist, in addition to their oral care, they must be alert to the risks of low birth weight and premature births. Infections in regions of the genitourinary tract, such as PD, may be associated with the occurrence of low birth weight newborns through the same mechanisms as other maternal and preterm birth infections. The contraction of the uterus and cervical dilation, acting as a trigger for premature birth, can be caused by inflammatory stimuli, which can induce hyperirritability of the uterine smooth muscles. The infection and the resulting inflammatory process can cause damage to the placenta, thereby restricting fetal development. Throughout life, a woman goes through several phases of hormonal fluctuations that, in addition to interfering with the reproductive system, exert influence on other organs and systems, such as the periodontium, particularly in the presence of preexisting gingival inflammation induced by plaque. During pregnancy, a woman is exposed to several significant hormonal changes, as the placenta produces high amounts of estrogen and progesterone, which in turn affect the oral tissues. It was concluded that black women aged over 40 years old are more likely to have PD, having a higher risk of low development to the fetus.

Association between Maternal Periodontitis and Development of Systematic Diseases in Offspring.

Periodontal disease (PD) is one of the most common oral conditions affecting both youths and adults. There are some research works suggesting a high incidence of PD in pregnant women. As an inflammatory disease of bacterial origin, PD may result in the activation of the pathways affecting the course and the pregnancy outcome. The authors, based on the literature review, try to answer the PICO question: Does maternal periodontitis (exposure) influence the incidence of complications rates in pregnancy and the development of systemic diseases in childhood and adult offspring (outcome) in the humans of any race (population) compared to the offspring of mothers with healthy periodontium (comparison)? The authors try to describe the molecular pathways and mechanisms of these interdependencies. There is some evidence that maternal periodontitis may affect the pregnancy course and outcome, resulting in preeclampsia, preterm delivery, vulvovaginitis and low birth weight. It can be suggested that maternal periodontitis may affect offspring epigenome and result in some health consequences in their adult life.

Is overweight associated with periodontitis in pregnant women? Systematic review and meta-analysis.

This systematic review and meta-analysis aimed to generate pooled evidence for the association between excessive weight and pregnancy induced periodontitis. EMBASE, SCOPUS, PubMed/MEDLINE, Web of Science, BVS/LILACS, Cochrane Library and SCIELO databases were accessed. Eligibility criteria were: human clinical studies published between year 2000 and 2021. Newcastle-Ottawa scale was used to evaluate risk of bias of the studies. Meta-analysis was performed using MedCalc® Statistical Software. Eleven studies were included, evaluating 2152 pregnant women (743 with overweight/obesity and 1409 with normal body mass index - BMI), with a mean age of 29.62 years. Most studies had low risk of bias. A positive association between overweight/obesity and periodontitis was found, with an average of 61.04% of women with overweight/obesity and periodontitis, showing the overall random-effects relative risk and 95% CI of 2.21 (1.53–3.17) (p < 0.001). Arterial hypertension, gestational diabetes mellitus and excessive gestational weight gain were the most common adverse effects of maternal obesity that may have been linked to periodontitis induced pro-inflammatory state. In conclusion, a positive association was found between overweight/obesity and periodontitis during pregnancy. However, the high heterogeneity between the studies related to sample size, periodontal classification and the cutoff-points for BMI are the main limitation.