Gynecology & Obstetrics
Open Access
ISSN: 2161-0932
ISSN: 2161-0932
Lumbreras Areta M, Gayet-Ageron A, Roux-Lombard P, Schrenzel J, Baehni P, Irion O and Martinez de Tejada B
Background: Comparing microbiologic and inflammatory markers of periodontitis with those of preterm birth (PTB).
Methods: Secondary analysis of a prior prospective case-control study done at the Geneva University Hospitals. Cases were women delivering at 22-34 6/7 weeks (early PTB, n=30) and controls were women delivering at ≥ 37 weeks (term delivery, n=87). We collected dental plaque during labour to quantify RNA levels from Aggregatibacter actinomycetemcomitans (Aa), Tannerella forsythia (Tf), Porphyromonas gingivalis (Pg) and Treponema denticola (Td). We also collected cord blood for cultures and cytokine quantification (IL-1Ra, IL-6, IL-8, IL-10, IL-17, TNF-α, MCP-1 and RANTES). Periodontal status was evaluated at the immediate postpartum using the American Consensus definition. Data was analysed by univariate and multivariate logistic regression.
Results: Levels of Pg and Td were significantly higher in dental plaque of women with severe and moderate periodontitis. Microbiologic composition of dental plaque was not different between preterm and term delivery groups. There were no differences in cord blood cultures between groups. Cord TNF-α ≥ 8 pg/ml and IL-10 ≥ 1.3 pg/ml were associated with a higher risk of periodontitis (OR 2.78, 95% CI: 1.09-7.13, P=0.033; OR 2.78, 95% CI: 1.09-7.08, P=0.032 respectively), but differences were not significant at multivariate analysis. Cord MCP-1 ≥ 350 pg/ml was associated with a higher risk of PTB at both univariate (OR 40.25, 95% CI: 6.79-238.48, P<0.001) and multivariate analysis (OR 53.71, 95% CI: 7.02-410.95, P<0.001).
Conclusion: In labour, microbiologic markers and inflammatory responses associated with periodontitis and PTB are different. The mechanisms linking periodontitis and PTB therefore still need to be elucidated.