Periodontal Status of Pregnant Women and Low Birth Weight of Infants-A Risk Assessment (An Epidemiologic Study (original) (raw)
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Relationship between maternal periodontal disease and low birth weight babies
2013
Background: Periodontal infections, which serve as a reservoir of inflammatory mediators, may pose a threat to the fetal-placental unit and cause adverse pregnancy outcomes. Objective: The aim of this study was assessing the periodontal status of women during puerperium and determining the possible relationship between their periodontal disease and low birth weight delivery. Materials and Methods: This was a case-control study. The sample included 88 ex-pregnant women were seen at maternity hospitals of Yazd, Iran. Half of the mothers had low birth babies (LBW) (birth weight below 2500g- case group) and the others had normal weight babies (>2500g- control group). The mothers’ data were obtained from medical files, interview and periodontal clinical examination carried out up to 3 days after delivery. Bleeding on probing, presence of supra-gingival calculus and CPITN (Community Periodontal Index for Treatment Needs) were used for periodontal assessment Results: Among the known risk factors of LBW babies, history of previous LBW infant among case mothers reached statistical significance (p=0.0081, Student t-test). Mothers of LBW infants had less healthy areas of gingiva (p=0.042), and more deep pockets (p=0.0006, Mann-Whitney test). Conclusion: The maternal periodontal disease can be a potential independent risk factor for LBW. Key Words: Periodontal disease, Low birth weight, community periodontal indexfor treatment needs
Maternal Periodontitis and Low Birth Weight Babies
Journal of Orofacial Research, 2013
Introduction: Low birth weight in developing countries is primarily because of poor maternal health and nutrition. If maternal health plays such an important role in the child's development, all the means of preventing problems among the pregnant women is of utmost importance.
Relationship between maternal periodontal disease and low-birth-weight pre-term infants
Journal of Clinical Periodontology, 2005
Objectives: The purpose of this study was to determine the influence of periodontal status on low-birth-weight pre-term delivery. Material and Methods: Ninety-six pregnant women were examined in their first, second and third trimester to record plaque scores, clinically assessed gingival inflammation and probing depth (mean depth and percentage of sites with depth of 43 mm). Binary logistic regression analyses were performed using SUDAAN 7.5 program. The type 1 (a) error established at 0.05 and an (a) error of 0.05-0.1 were considered nearly significant. Results: The 96 women delivered 89 newborns: 16 were pre-term and seven of these were of low birth weight. There were seven miscarriages, all in the second trimester. No statistically significant association was found between gestational age and periodontal parameters. No significant relationship was found between low-weight delivery and plaque index measurements, although the association with gingival index was close to significant. A relationship was observed between low-weight birth and probing depth measurements, especially the percentage of sites of 43 mm depth, which was statistically significant (p 5 0.0038) even when gestational age was controlled for. Conclusions: According to these results, periodontal disease is a significant risk factor for low birth weight but not for pre-term delivery.
Correlation of Periodontitis during Pregnancy and Incidence of Low Birth Weight Babies
Journal of Indian Academy of Oral Medicine and Radiology, 2012
Objective: To verify a possible association between periodontitis and low birth weight babies. Materials and methods: Two hundred and eighty antepartum women were examined aged between 18 and 37 years. Demographic, medical and clinical histories were taken under obstetrician's guidance. A thorough periodontal examination was done in all the participants with their consent which included bleeding on probing, pocket depth and clinical attachment level. After delivery, gestational age (in weeks) and birth weight of baby (in kg) were collected from hospital records. Infants were placed into following categories by gestational age (WHO) and by birth weight preterm-<37 weeks, term-37 to 42 weeks, post-term-42 weeks completed and above, low birth weight-<2,500 gm, normal birth weight-2,500 to 3,900 gm, high weight->3,900 gm. Results: Based on the findings of the study, a significant correlation was observed between periodontitis and low birth weight and preterm low birth weight (p ≤0.001) and a significant relation was observed between periodontitis and gestational age (p < 0.001). Conclusion: Periodontitis was considered a risk indicator for reduced gestational age and birth weight. Multicentric trials will greatly help to establish the independent role of periodontal disease and their relationship in terms of pregnancy outcomes.
INTRODUCTION Periodontitis is a complex microbial disease affecting the supporting structures of the tooth. It is initiated by oral pathogens and is considered that the severity of periodontal disease is dependent on the response of host to periodontal pathogens. [1] The concept that periodontal disease might influence systemic health is not new. In 1900, William Hunter [2] , a British Physician identified gingivitis and periodontitis as foci of infection. He advocated extraction of teeth with these conditions to eliminate the source of sepsis. The focal infection theory fell into disrepute in the 1940s and 1950s when extraction of the entire dentition failed to reduce or eliminate the systemic conditions. However, it was not until the last decade of the twentieth century that dentistry and medicine again began to examine the relationship of oral infection as a risk for systemic disease. Preterm low birth weight (PLBW) is defined as an adverse pregnancy outcome where the infant weighs less than 2,500 gms and born before 37 weeks of gestational age. [3] It is a well-recognized fact that, PLBW is associated with increased morbidity, mortality, and societal cost across the world. It is one of the leading causes of death in infants. Background: There is growing evidence showing that a number of complex human diseases are caused or are at least influenced by periodontal diseases. Such diseases include cardiovascular diseases, respiratory diseases, diabetes mellitus, and osteoporosis. Aim: The aim of the present study was to evaluate periodontal diseases as a risk factor for preterm low birth weight infants. Methods: A case‑control study with a selection ratio of 1:1 was performed using 150 cases and 150 controls, who delivered their babies at Vanivilas Hospital, Bangalore, India, over a 3‑months period from January 2012–March 2012. Cases were defined as mothers delivering an infant weighing less than 2,500 gms and born before 37‑weeks gestation. Controls were mothers delivering an infant weighing more than 2,500 gms and born after 38‑weeks gestation. Patients were evaluated for age, socioeconomic status, obstetric risk, nutritional status, maternal morbidity, infections, toxic exposure, antenatal care, infant characters, through hospital records and personal questionnaire by incharge team members. Oral examination was performed using Extent and severity index, Sulcus Bleeding Index. Results: Cases and controls did not reveal any significant difference when compared for age, socioeconomic status, obstetric risk, nutrition, maternal morbidity, and antenatal care. Periodontal disease was more severe and extensive in cases when compared with control and the difference was statistically significant (P<0.001). Bleeding index scores were higher in cases as compared to control and was statistically significant (P<0.001). Conclusion: Within the limits of this study, it is concluded that a poor periodontal health status of the mother may be a potential risk factor for a preterm low birth weight.
Effect of Periodontal Infection on Birth Weight of Infants: A Clinical and Microbiological Study*
Open Journal of Medical Microbiology, 2013
Maternal periodontal infection has been proposed to influence pre-term delivery and low birth weight infants through mechanisms involving inflammatory mediators or direct bacterial assault on the amnion. Thus, the aim of the present study was to assess the presence of periodontal pathogens in maternal periodontal infection and their effect on the birth weight of infants. Materials and Methods: The case-control study included 30 mothers with a singleton gestation and gestational age of >37 weeks. Data regarding the periodontal status, pregnancy outcome variables, hemoglobin levels (Hb%) and other factors that may influence adverse pregnancy outcomes were collected. A qualitative analysis of the predominant anaerobic organisms was conducted. The data was analysed using one-way ANOVA test and Scheffe's test. Results: The microbiological results showed that prevalent colonies of organisms isolated from the experimental groups were of Bacteroides spp. (n = 3), Fusobacterium spp. (n = 3) and Peptostreptococcus spp. (n = 9). In the control group, Peptostreptococcus spp. (n = 15) were predominant. In the experimental group, it was seen that Bacteroides spp. (p = 0.003) and Fusobacterium spp. (p = 0.050) were statistically significant with the birth weight of the infant. The one-way ANOVA test showed that the birth weight of the infant was inversely proportionate with increase in severity of the periodontal disease. Scheffe's test showed that presence of a periodontal pocket showed most significance to the birth weight of an infant as compared to presence of local factors or bleeding on probing. Conclusion: The study revealed that the gram negative organisms, Bacteroides spp. and Fusobacterium spp. were significantly associated with the low birth weight (LBW) of the infants, although there was not a significant difference in the clinical periodontal status between the experimental groups and the controls. It could be proposed that specific groups of pathogens may have a contributory role in the risk of LBW.
Low birth weight (LBW) infants are those that weigh less than 2500g at the time of birth. They are 40 times more likely to die than normal weight infants are. The primary cause of LBW babies is preterm labor or premature rupture of membranes. Factors such as smoking, alcohol or drug abuse during pregnancy, inadequate prenantal care, race, low socio-economic status, hypertension, high or low maternal age, diabetes and chronic maternal infection, increase the risk of LBW babies. Periodontitis is a remote gram-negative infection that may play a role in LBW. Periodontopathic microorganisms and their products have wide range of effects mediated through host cytokine production in target cells. Many combined animal studies and data supporting plausible biological mechanisms suggest that periodontal infection has a negative impact on pregnancy outcome in some women.
Association of periodontitis with pre term low birth weight – A review
Placenta, 2020
Prematurity is one of the main causes of neonatal morbidity and mortality. The association between periodontitis and premature delivery and low weight at birth has been suggested in many literature. Pregnancy totally depends on physiological immune tolerance of a women. During pregnancy shifts in the microbial composition of the subgingival dental plaque biofilm promotes the formation of more hazardous and destructive microbial community. In women suffering with periodontitis, the infected periodontal tissues may act as source of bacteria and their products can reach to the foetus-placenta unit through circulation. This helps the bacterial agents and their products to activate inflammatory signalling pathways locally and in extra-oral sites, including the placenta-foetal unit, which may not only induce preterm labor but also restrict the intrauterine growth. Number of literature has shown about the effectiveness of providing periodontal treatment in preventing gestational complications by controlling the infection and inflammation in periodontitis patients during pregnancy. In this review we aimed to throw the light on the current data of association between pregnancy and periodontitis, pathogenic mechanisms underlying this association, evidence of this association and effect of providing periodontal treatment as a safety precaution to the mothers. 2. Complications of preterm birth to the infant [7] During the neonatal period (first 28 days) and infancy (first year