Abstract
Introduction
The physiological changes in mother-infant pairs during pregnancy increase the susceptibility to a series of infections, including those of the oral cavity. Therefore, the oral and systemic health of pregnant women is related to adverse pregnancy outcomes.
Objective
This cross-sectional study aimed to evaluate the systemic profile and periodontal status of women with a high-risk pregnancy.
Methods
Eighty-nine pregnant women at risk of preterm labor admitted to a hospital in southern Brazil were interviewed and received a periodontal examination. Data related to obstetric complications during pregnancy (pre-eclampsia, infections, medication use, and gestational diabetes) and systemic diseases were collected from medical records. The periodontal parameters of probing pocket depth, bleeding on probing, and clinical attachment level were evaluated. The data were tabulated, and statistical analysis was performed (p < 0.05).
Results
The mean age of participants was 24 years (SD = 5.62). Gingival bleeding was recorded in 91% of the participants. The prevalence of gingivitis was 31.46%, and periodontitis was 29.21%. No association between systemic conditions and periodontal disease was observed.
Conclusions and Implications for Practice
Periodontal inflammation was not associated with the systemic profile during pregnancy. However, women with high-risk pregnancies showed higher levels of gingival inflammation, emphasizing the importance of dental care during pregnancy.
Significance
The gestational period is marked by a series of physiological changes that can be influenced by local and systemic conditions. Thus, investigating the periodontal status of pregnant women considered at risk for premature birth and evaluating associations with the systemic health of these patients can present important risk indicators for maternal and fetal health.
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References
O’Neil, A., T. C (1979). Maternal T-Lymphocyte response and gingivitis in pregnancy. Journal of Periodontology, 50(4), 178–184. https://doi.org/10.1902/jop.1979.50.4.178.
Benhalima, K., Van Crombrugge, P., Moyson, C., Verhaeghe, J., Vandeginste, S., Verlaenen, H., Vercammen, C., Maes, T., Dufraimont, E., De Block, C., Jacquemyn, Y., Mekahli, F., De Clippel, K., Van Den Bruel, A., Loccufier, A., Laenen, A., Minschart, C., Devlieger, R., & Mathieu, C. (2019). Characteristics and pregnancy outcomes across gestational diabetes mellitus subtypes based on insulin resistance. Diabetologia, 62(11), 2118–2128. https://doi.org/10.1007/s00125-019-4961-7.
Bett, J. V. S., Batistella, E., Melo, G., Munhoz, E., de Silva, A., Guerra, C. A. B., da Porporatti, E. N., A. L., & De Luca Canto, G. (2019). Prevalence of oral mucosal disorders during pregnancy: A systematic review and meta-analysis. In Journal of Oral Pathology and Medicine (Vol. 48, Issue 4, pp. 270–277). Blackwell Publishing Ltd. https://doi.org/10.1111/jop.12831
Billionnet, C., Mitanchez, D., Weill, A., Nizard, J., Alla, F., Hartemann, A., & Jacqueminet, S. (2017). Gestational diabetes and adverse perinatal outcomes from 716,152 births in France in 2012. Diabetologia, 60(4), 636–644. https://doi.org/10.1007/s00125-017-4206-6.
Botero, J. E., Rösing, C. K., Duque, A., Jaramillo, A., & Contreras, A. (2015). Periodontal disease in children and adolescents of Latin America. Periodontology 2000, 67(1), 34–57. https://doi.org/10.1111/prd.12072.
Bramham, K., Parnell, B., Nelson-Piercy, C., Seed, P. T., Poston, L., & Chappell, L. C. (2014). Chronic hypertension and pregnancy outcomes: Systematic review and meta-analysis. BMJ (Online), 348. https://doi.org/10.1136/bmj.g2301.
Carrillo-De-Albornoz, A., Figuero, E., Herrera, D., Cuesta, P., & Bascones-Martínez, A. (2012). Gingival changes during pregnancy: III. Impact of clinical, microbiological, immunological and socio-demographic factors on gingival inflammation. Journal of Clinical Periodontology, 39(3), 272–283. https://doi.org/10.1111/j.1600-051X.2011.01800.x.
Caton, J., Armitage, G., Berglundh, T., Chapple, I. L. C., Jepsen, S., Kornman, S., Mealey, K. L., Papapanou, B., Sanz, P. N., M., & Tonetti, S., M (2018). A new classification scheme for periodontal and peri-implant diseases and conditions – introduction and key changes from the 1999 classification. Journal of Clinical Periodontology, 45(March), S1–S8. https://doi.org/10.1111/jcpe.12935.
Chapple, I. L. C., Mealey, B. L., Van Dyke, T. E., Bartold, P. M., Dommisch, H., Eickholz, P., Geisinger, M. L., Genco, R. J., Glogauer, M., Goldstein, M., Griffin, T. J., Holmstrup, P., Johnson, G. K., Kapila, Y., Lang, N. P., Meyle, J., Murakami, S., Plemons, J., Romito, G. A., & Yoshie, H. (2018). Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World workshop on the classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of Clinical Periodontology, 45, S68–S77. https://doi.org/10.1111/jcpe.12940.
Conde-Agudelo, A., Villar, J., & Lindheimer, M. (2008). Maternal infection and risk of preeclampsia: Systematic review and metaanalysis. In American Journal of Obstetrics and Gynecology. American Journal Of Obstetrics And Gynecology, 198(1), 7–22. https://doi.org/10.1016/j.ajog.2007.07.040.
Cota, L. O. M., Guimarães, A. N., Costa, J. E., Lorentz, T. C. M., & Costa, F. O. (2006). Association between maternal periodontitis and an increased risk of Preeclampsia. Journal of Periodontology, 77(12), 2063–2069. https://doi.org/10.1902/jop.2006.060061.
DATASUS (2017). TabNet Win32 3.0: Nascidos vivos - Brasil. Ministério Da Saúde. http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sinasc/cnv/nvuf.def
Figueiredo, C., Rosalem, C. G. C., Cantanhede, A. L. C., Thomaz, É. B. A. F., & Cruz, M. C. F. N. da. (2017). Systemic alterations and their oral manifestations in pregnant women.Journal of Obstetrics and Gynaecology Research, 43(1),16–22. https://doi.org/10.1111/jog.13150
Figuero, E., Carrillo-De-Albornoz, A., Herrera, D., & Bascones-Martínez, A. (2010). Gingival changes during pregnancy: I. influence of hormonal variations on clinical and immunological parameters. Journal of Clinical Periodontology, 37(3), 220–229. https://doi.org/10.1111/j.1600-051X.2009.01516.x.
Figuero, E., Han, Y. W., & Furuichi, Y. (2020). Periodontal diseases and adverse pregnancy outcomes: Mechanisms. In Periodontology 2000 (Vol. 83, Issue 1, pp. 175–188). Blackwell Munksgaard. https://doi.org/10.1111/prd.12295
Geidel, A., Krüger, M., Schrödl, W., & Jentsch, H. (2017). Control of Plaque and Gingivitis by an Herbal Toothpaste - A Randomised Controlled Study. Oral Health & Preventive Dentistry, 15(5), 407–413. https://doi.org/10.3290/j.ohpd.a38975.
Genco, R. J., & Borgnakke, W. S. (2013). Risk factors for periodontal disease. Periodontology 2000, 62(1), 59–94. https://doi.org/10.1111/j.1600-0757.2012.00457.x.
González-Jaranay, M., Téllez, L., Roa-López, A., Gómez-Moreno, G., & Moreu, G. (2017). Periodontal status during pregnancy and postpartum. Plos One, 12(5), 1–9. https://doi.org/10.1371/journal.pone.0178234.
Gürsoy, M., Pajukanta, R., Sorsa, T., & Könönen, E. (2008). Clinical changes in periodontium during pregnancy and post-partum. Journal of Clinical Periodontology, 35(7), 576–583. https://doi.org/10.1111/j.1600-051X.2008.01236.x.
Instituto Brasileiro de Geografia e Estatística - IBGE (2010). IBGE Censo 2010. In Instituto Brasileiro de Geografia e Estatística. https://censo2010.ibge.gov.br/
Jung, E., Romero, R., Yeo, L., Gomez-Lopez, N., Chaemsaithong, P., Jaovisidha, A., Gotsch, F., & Erez, O. (2022). The etiology of preeclampsia. American Journal of Obstetrics and Gynecology, 226(2S), S844–S866. https://doi.org/10.1016/J.AJOG.2021.11.1356.
Kashetty, M., Kumbhar, S., Patil, S., & Patil, P. (2018). Oral hygiene status, gingival status, periodontal status, and treatment needs among pregnant and nonpregnant women: A comparative study. Journal of Indian Society of Periodontology, 22(2), 164–170. https://doi.org/10.4103/jisp.jisp_319_17.
Kataoka, M., Kido, J. I., Shinohara, Y., & Nagata, T. (2005). Drug-induced gingival overgrowth - A review. Biological and Pharmaceutical Bulletin, 28(10), 1817–1821. https://doi.org/10.1248/bpb.28.1817.
Knottnerus, A., & Tugwell, P. (2008). STROBE-A checklist to STrengthen the reporting of OBservational studies in Epidemiology. In Journal of Clinical Epidemiology. Journal Of Clinical Epidemiology, 61(4), 323. https://doi.org/10.1016/j.jclinepi.2007.11.006.
Krüger, M. S. M., Casarin, R. P., Pinto, G. S., Pappen, F. G., Camargo, M. B. J., Correa, F. O. B., & Romano, A. R. (2019). Maternal periodontal disease and adverse perinatal outcomes: Is there an association? A hospital-based case-control study. Journal of Maternal-Fetal and Neonatal Medicine, 32(20), 3401–3407. https://doi.org/10.1080/14767058.2018.1464554.
Leite, F. R. M., Nascimento, G. G., Scheutz, F., & López, R. (2018). Effect of smoking on Periodontitis: A systematic review and Meta-regression. American Journal of Preventive Medicine, 54(6), 831–841. https://doi.org/10.1016/j.amepre.2018.02.014.
Llambés, F. (2015). Relationship between diabetes and periodontal infection. World Journal of Diabetes, 6(7), 927. https://doi.org/10.4239/wjd.v6.i7.927.
Manrique-Corredor, E. J., Orozco-Beltran, D., Lopez-Pineda, A., Quesada, J. A., Gil-Guillen, V. F., & Carratala-Munuera, C. (2019). Maternal periodontitis and preterm birth: Systematic review and meta-analysis. Community Dentistry and Oral Epidemiology, 47(3), 243–251. https://doi.org/10.1111/cdoe.12450.
da Ministério, B. (2010). Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Ações Programáticas Estratégicas. Gestação de alto risco: manual técnico / Ministério da Saúde, Secretaria de Atenção à Saúde, Departamento de Ações Programáticas Estratégicas. –. www.saude.gov.br/bvsSecretariadeVigilânciaemSaúdewww.saude.gov.br/svs
Muñoz Aguilera, E., Suvan, J., Buti, J., Czesnikiewicz-Guzik, M., Barbosa Ribeiro, A., Orlandi, M., Guzik, T. J., Hingorani, A. D., Nart, J., & D’Aiuto, F. (2020). Periodontitis is associated with hypertension: A systematic review and meta-analysis. Cardiovascular Research (116 vol., pp. 28–39). Oxford University Press. 1https://doi.org/10.1093/cvr/cvz201.
Musskopf, M. L., Milanesi, F. C., da Rocha, J. M., Fiorini, T., Moreira, C. H. C., Susin, C., Rösing, C. K., Weidlich, P., & Oppermann, R. V. (2018). Oral health related quality of life among pregnant women: A randomized controlled trial. Brazilian Oral Research, 32, https://doi.org/10.1590/1807-3107bor-2018.vol32.0002.
Negrato, C. A., Mattar, R., & Gomes, M. B. (2012). Adverse pregnancy outcomes in women with diabetes. In diabetology and metabolic syndrome. BioMed Central, 4(1), 41. https://doi.org/10.1186/1758-5996-4-41.
Page, R. C., & Kornman, K. S. (1997). The pathogenesis of human periodontitis: An introduction. Periodontology 2000, 14, 9–11. https://doi.org/10.1111/j.1600-0757.1997.tb00189.x.
Puertas, A., Magan-Fernandez, A., Blanc, V., Revelles, L., O’Valle, F., Pozo, E., León, R., & Mesa, F. (2018). Association of periodontitis with preterm birth and low birth weight: A comprehensive review. Journal of maternal-fetal and neonatal medicine (31 vol., pp. 597–602). Taylor and Francis Ltd. 5https://doi.org/10.1080/14767058.2017.1293023.
Raber-Durlacher, J. E., van Steenbergen, T. J. M., van der Velden, U., de Graaff, J., & Abraham‐Inpijn, L. (1994). Experimental gingivitis during pregnancy and post‐partum: Clinical, endocrinological, and microbiological aspects. Journal of Clinical Periodontology, 21(8), 549–558. https://doi.org/10.1111/j.1600-051X.1994.tb01172.x.
Rahmani, A., Hamanajm, S. A., Allahqoli, L., & Fallahi, A. (2019). Factors affecting dental cleaning behaviour among pregnant women with gingivitis. International Journal of Dental Hygiene, 17(3), 214–220. https://doi.org/10.1111/idh.12387.
Shen, M., Smith, G. N., Rodger, M., White, R. R., Walker, M. C., & Wen, S. W. (2017). Comparison of risk factors and outcomes of gestational hypertension and pre-eclampsia. Plos One, 12(4), https://doi.org/10.1371/journal.pone.0175914.
Silness, J., & Löe, H. (1964). Periodontal Disease in pregnancy II. Correlation between oral Hygiene and Periodontal Condition. Acta Odontologica Scandinavica, 22(1), 121–135. https://doi.org/10.3109/00016356408993968.
Tonetti, M. S., Greenwell, H., & Kornman, K. S. (2018). Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. Journal of Periodontology, 89, S159–S172. https://doi.org/10.1002/JPER.18-0006.
United Nations Children’s Fund and World Health (2004). Low Birthweight: Country, regional and global estimates. UNICEF. https://apps.who.int/iris/handle/10665/43184
Varshney, S., & Gautam, A. (2014). Poor periodontal health as a risk factor for development of pre-eclampsia in pregnant women. Journal of Indian Society of Periodontology, 18(3), 321. https://doi.org/10.4103/0972-124X.134569.
Vivares-Builes, A. M., Rangel-Rincón, L. J., Botero, J. E., & Agudelo-Suárez, A. A. (2018). Gaps in knowledge about the Association between maternal periodontitis and adverse obstetric outcomes: An Umbrella Review. Journal of Evidence-Based Dental Practice, 18(1), 1–27. https://doi.org/10.1016/j.jebdp.2017.07.006.
Wei, Y., Xu, Q., Yang, H., Yang, Y., Wang, L., Chen, H., Anderson, C., Liu, X., Song, G., Li, Q., Wang, Q., Shen, H., Zhang, Y., Yan, D., Peng, Z., He, Y., Wang, Y., Zhang, Y., Zhang, H., & Ma, X. (2019). Preconception diabetes mellitus and adverse pregnancy outcomes in over 6.4 million women: A population-based cohort study in China. PLoS Medicine, 16(10), https://doi.org/10.1371/journal.pmed.1002926.
WHO. (2018). Global recommendations for routine Antenatal Care. World Health Organisation, 10(1), 1–10. https://doi.org/10.1186/1742-4755-10-19.5.
Acknowledgements
This study was conducted in a University Hospital. The authors report no conflicts of interest. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) – Finance Code 001.
Funding
This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) – Finance Code 001.
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Bruna Silva Schievelbein had a substantial contribution to the conception and designing the current study. She also contributed to the writing and organization of the manuscript. She agreed on all aspects of this work ensuring that any questions related to the accuracy or integrity of any part were appropriately investigated and solved, approving the final version to be published. Renata Picanço Casarin and Marta Silveira da Mota Kruger had a substantial contribution to the conception, patients’ exams, and acquisition of the data. They agreed on all aspects of this work ensuring that any questions related to the accuracy or integrity of any part were appropriately investigated and solved, approving the final version to be published. Caroline Fernandes e Silva and Taciane Menezes da Silveira had a substantial contribution to the designing of the current study. They also contributed to the writing and organization of the manuscript. They agreed on all aspects of this work ensuring that any questions related to the accuracy or integrity of any part were appropriately investigated and solved, approving the final version to be published. Ana Regina Romano and Fernanda Geraldo Pappen had a substantial contribution to the data analyses, results synthesis, and paper review. They agreed on all aspects of this work ensuring that any questions related to the accuracy or integrity of any part were appropriately investigated and solved, approving the final version to be published. Natália Marcumini Pola had a substantial contribution to the conception, designing of the current study and drafting process of the manuscript. She agreed on all aspects of this work ensuring that any questions related to the accuracy or integrity of any part were appropriately investigated and solved.
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The institutional Ethics Committee in Research of the Medical School of the Federal University of Pelotas approved this study (OF80/2012).
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Schievelbein, B.S., Casarin, R.P., da Mota Kruger, M.S. et al. Systemic Profile and Periodontal Condition of Hospitalized Women with High-Risk Pregnancy: A Cross-Sectional Study. Matern Child Health J 27, 1264–1271 (2023). https://doi.org/10.1007/s10995-023-03659-8
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DOI: https://doi.org/10.1007/s10995-023-03659-8