Association between high risk for preterm birth and changes in gingiva parameters during pregnancy—a prospective cohort study
The objective of this study was to investigate clinical and microbiological gingival changes during pregnancy in women without periodontal disease. Additionally, these parameters were to be compared in women with high risk for preterm birth and women with a normal course of pregnancy.
Method and materials
Group I consisted of 40 subjects at high risk for preterm birth, while group II involved 49 subjects with a normal course of pregnancy. The control group (III) was made up of 50 non-pregnant women. Clinical parameters (plaque index, gingival index, probing pocket depths, gingival swelling, bleeding on probing) and microbiological changes were monitored during pregnancy and 2–4 weeks after parturition.
In the high-risk preterm group (I), 19 women could be included in data analysis. This group was compared to 41 women in the normal pregnancy group (II) and 50 non-pregnant women (III). Gingival inflammation was significantly higher in women with high risk for preterm birth (I) compared to non-risk pregnant women (II, p < 0.05). In addition, in this group (I), the subgingival amounts of Fusobacterium nucleatum (> 105) were found to be significantly higher after childbirth compared to non-pregnant women (p < 0.05).
Even without having periodontal disease, women with high risk for preterm birth showed worse clinical values compared to non-risk pregnant and non-pregnant women and an increased detection of Fusobacterium nucleatum after delivery.
High risk for preterm birth might be associated with the occurrence of increased gingival inflammation.
KeywordsPreterm birth Pregnancy Periodontal Gingivitis Microbiology
The authors like to thank Markus Kaiser, Barbara Dannenhauer, Dr. Julia Blank, Dr. Susanne Proksch, and Prof. Nadine Schlüter for supporting the practical realization and publication of this study.
ACK and PRK developed the research question; ABK, ACK, MK, JPW, AA, KV, and PRK developed the study protocol; ACK, ABK, and JPW conducted the clinical examinations; AA and AW conducted the microbiological analysis; KV conducted the statistical analysis; ABK drafted the primary version of the paper; and ACK, PRK, MK, JPW, AA, and AW finalized the paper and approved the final version.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Availability of data and materials
The dataset supporting the conclusions of this article is included within the article and its additional files.
- 18.Tonetti MS, Claffey N (2005) European Workshop in Periodontology group C. Advances in the progression of periodontitis and proposal of definitions of a periodontitis case and disease progression for use in risk factor research. Group C consensus report of the 5th European Workshop in Periodontology. J Clin Periodontol 32(Suppl 6):210–213CrossRefPubMedGoogle Scholar
- 21.Cosyn J, De Bruyn H, Sabzevar MM (2007) Subgingival application of chlorhexidine in the treatment of periodontitis. Rev Belge Médecine Dent 62(4):176–182Google Scholar
- 23.Kim JK, Baker LA, Seirawan H, Crimmins EM (2012) Prevalence of oral health problems in U.S. adults, NHANES 1999-2004: exploring differences by age, education, and race/ethnicity. Spec Care Dent Off Publ Am Assoc Hosp Dent Acad Dent Handicap Am Soc Geriatr Dent 32(6):234–241Google Scholar