Association of preterm low-birth-weight infants and maternal periodontitis during pregnancy An interventional study

Context: The impact of periodontal disease during pregnancy and its effect on adverse pregnancy outcomes is seen in the literature. When it comes to the link of disease related to periodontium to that of adverse pregnancy outcomes, a need can arise if a significant cause-effect relationship does exist or not between them. Aim: The study was aimed to determine the association of periodontal health status in pregnant women with the occurrence of preterm low birth weight (LBW) infants in Vadodara, Gujarat. Settings and Design: An interventional study with 100 patients was conducted, of which 67 participants were included in the control group and 33 participants were included in the intervention group. A total of 12 participants dropped out from the study and 88 were analyzed for the outcome. Subjects and Methods: The Community periodontal Index of Treatment needs index was taken for all enrolled participants and then were divided into interventional group and control group. Participants in the interventional group underwent scaling and root planning. Data related to the time of delivery and weight of the baby was taken from the hospital records. Statistical Analysis: A comparison of baseline characteristics was made using unpaired t-test. Chi-square test was used for the analysis of intergroup comparison. The odds ratio and the relative risk calculation were also done. P ? 0.05 was considered for statistical significance. Results: The odds ratio for both preterm and LBW were 3.86 times and 2.96, respectively. The Chi-square statistical test analysis was statistically significant for both preterm and LBW infants on the intergroup comparison. Conclusion: Periodontal disease can be considered as one of the risk factors for preterm LBW babies as not only the presence of disease condition causes an increase in inflammatory mediator but also the elimination of the disease condition reduces the adverse pregnancy outcomes.

The relationship between maternal periodontal disease and preterm low birth weight / 口腔疾病防治

@# Preterm low birth weight newborns are prone to complications during growth and development, such as growth retardation and infectious diseases, and the mortality rate of high-risk infants is higher than that of healthy newborns. Epidemiological data show that periodontal disease in pregnant women is correlated with preterm low birth weight. Periodontal disease in pregnant women is one of the risk factors for adverse pregnancy outcomes, such as  preterm   low birth weight. This paper addresses the correlation between maternal periodontal disease and  preterm  low birth weight, the influence of periodontal treatment on the incidence of preterm  low birth weight, and premature birth caused by maternal periodontal disease. The mechanism of infant weight is reviewed. The results of this review show that the current studies confirm the correlation between maternal periodontal disease and  preterm low birth weight. However, the causal relationship between maternal periodontal disease and preterm  low birth weight is not fully elucidated, and the specific mechanism and approach are not clear. A possible mechanism is that periodontal pathogens in pregnant women pass through the placental barrier to influence pregnancy outcomes. Therefore, more in-depth research is needed on the specific mechanism, approach, intervention and treatment based on the relationship between these two factors.

Associations between maternal exposure to chemical fertilizers during pregnancy and the risk of offspring's low birth weights / 中华流行病学杂志

Objective To explore the association between the consumption of chemical fertilizers and the risk of low birth weight (LBW),to provide references for prevention programs on LBW and to improve the birth outcomes.Methods Stratified multivariate logistic regression method was used in this study involving 153 preterm LBW infants,179 term LBW infants and 204 normal control infants that were randomly selected from the birth monitoring data between October 2007 and September 2012 in Pingding county,Shanxi province.Associations between the risk of LBW and maternal exposure to chemical fertilizers during pregnancy were identified.A normal control group was set up to compare results between preterm and term LBW groups.Results Totally,18 749infants were born between 2007 and 2012,with the total incidence rates of LBW as 48.5‰,preterm LBW as 19.4‰,and term LBW as 29.1‰.Concerning the case control study on preterm LBW,after adjustment for confounding factors,the risk of preterm LBW appeared 2.51 (95％CI:1.05-5.99) times higher in villages with annual consumption of chemical fertilizer ≥ 100 tons than those villages that using chemical fertilizer less than 50 tons.No significant statistical associations were found between the amounts of household chemical fertilizer consumption and the risks of preterm LBW.Regarding the case control study on term LBW,after adjustment for confounding factors,in villages with ≥ 100tons annual consumption of chemical fertilizers,the risk of term LBW was 4.03 (95％CI:1.63-9.92)times of the risk in villages where the annal use of chemical fertilizers was less than 50 tons.There was no significant association between household consumption of chemical fertilizers and the risk of term LBW.Conclusions Maternal exposure to chemical fertilizers during pregnancy was associated with the risk of LBW.Our findings suggested that the amount of chemical fertilizer consumption in rural areas seemed also associated with the risks of other adverse pregnancy outcomes.Women should avoid the chance of exposure to chemical fertilizers during pregnancy and the consumption of chemical fertilizers should be carefully managed.

Associations between maternal exposure to chemical fertilizers during pregnancy and the risk of offspring's low birth weights / 中华流行病学杂志

Objective To explore the association between the consumption of chemical fertilizers and the risk of low birth weight (LBW),to provide references for prevention programs on LBW and to improve the birth outcomes.Methods Stratified multivariate logistic regression method was used in this study involving 153 preterm LBW infants,179 term LBW infants and 204 normal control infants that were randomly selected from the birth monitoring data between October 2007 and September 2012 in Pingding county,Shanxi province.Associations between the risk of LBW and maternal exposure to chemical fertilizers during pregnancy were identified.A normal control group was set up to compare results between preterm and term LBW groups.Results Totally,18 749infants were born between 2007 and 2012,with the total incidence rates of LBW as 48.5‰,preterm LBW as 19.4‰,and term LBW as 29.1‰.Concerning the case control study on preterm LBW,after adjustment for confounding factors,the risk of preterm LBW appeared 2.51 (95％CI:1.05-5.99) times higher in villages with annual consumption of chemical fertilizer ≥ 100 tons than those villages that using chemical fertilizer less than 50 tons.No significant statistical associations were found between the amounts of household chemical fertilizer consumption and the risks of preterm LBW.Regarding the case control study on term LBW,after adjustment for confounding factors,in villages with ≥ 100tons annual consumption of chemical fertilizers,the risk of term LBW was 4.03 (95％CI:1.63-9.92)times of the risk in villages where the annal use of chemical fertilizers was less than 50 tons.There was no significant association between household consumption of chemical fertilizers and the risk of term LBW.Conclusions Maternal exposure to chemical fertilizers during pregnancy was associated with the risk of LBW.Our findings suggested that the amount of chemical fertilizer consumption in rural areas seemed also associated with the risks of other adverse pregnancy outcomes.Women should avoid the chance of exposure to chemical fertilizers during pregnancy and the consumption of chemical fertilizers should be carefully managed.

Periodontitis as a potential risk factor for preterm low birth weight / Шинэ санаа Шинэ нээлт

@#Preterm birth is not only health problem but also one of major socioeconomic issues. Preterm Low Birth Weight (PLBW) is leading causative factor of neonatal mortality. Some researches results showed that during periodontal inflammatory disorder some bacterial components could affect pregnancy and fetal development. Therefore aim of our study is to assess and confirm periodontal disease of pregnant females whether or not risk factor of PLBW. We performed our study on the First Maternity Hospital and National Centre for Maternal and Child Health of Mongolia by clinical based case control method on 90 participants. Case group has 30 females (<37 weeks of gestation, and Neonates Birth Weight <2500), control group has 60 females (Normal birth) (ratio was 1:2). Dental caries prevalence on control group was 99%, the mean of DFM/t was 8.32 “average”, prevalence of case group was 100%, and mean of DFM/t was 11.33, which was also “average”. Oral hygiene examination assessment was poor. Study results showed that patients with periodontal disease such as dental calculus (***p<0.008) and periodontal pocket with depth of 4-6mm (***p<0.006) were risk factors for PLBW. Gingivitis is increased to have PLBW baby by 5.5 times. CPITN index was highly associated with dental hygiene index and it was statistically significant. (***p<0.000). Within the limits of this study poor periodontal health status of mothers may be a potential risk factor for a preterm low birth weight.

Awareness of the association between periodontal disease and adverse pregnancy outcome among the general female population.

Background: Preterm low birth weight (PTLBW) is a public health issue which needs to be dealt with by educating the general female population. One of the major contributing factors is periodontal disease and treatment of the same could reduce the occurrence of PTLBW babies. Therefore, awareness of this among the female population is highly essential. Hence, this survey was planned with the aim to explore the awareness of the general female population regarding the association of periodontal disease and PTLBW. Material and Methods: This survey consisted of nine close‑ended questions answered by 1284 females. Results: Younger individuals had higher knowledge scores as compared to the older individuals (r = −0.161) and the more educated group had a higher knowledge score as compared to the less educated groups (r = 0.322). Furthermore, married women seemed to be more aware of the relation of PTLBW to periodontal disease as compared to unmarried women. Conclusion: Younger and educated females had better awareness of the association between periodontal diseases and PTLBW. Hence, efforts to educate the general female population on this association could contribute toward the reduction of the risk of PTLBW.

Association between gingival crevicular fluid prostaglandin E 2 level and preterm low birth weight.

Background: Periodontal infections, which serve as a reservoir of inflammatory mediators such prostaglandin E 2 (PGE 2 ), may pose a threat to the fetal-placental unit and cause preterm delivery. Aim: This study was conducted to estimate the PGE 2 levels in gingival crevicular fluid (GCF) and to explore the association between GCF-PGE 2 levels and preterm low birth weight (PLBW). Materials and Methods: Twenty-two pregnant patients were selected for the study. GCF samples were collected from these patients before delivery and again at 1 month after delivery. PGE 2 level was estimated using a commercially available ELISA kit (Neogen™). Results: The mean GCF-PGE 2 level was 5.8 ng/ml before parturition and 5.5 ng/ml after parturition, but the difference was not statistically significant. There was negative correlation between PGE 2 levels and gestational age at birth. Conclusion: The study provides weak evidence that there is correlation between GCF-PGE 2 levels and birth outcome. Further clinical trials with large samples are required to confirm the association between GCF-PGE 2 levels and PLBW.

Awareness of association between periodontitis and PLBW among selected population of practising gynecologists in Andhra Pradesh.

Context: Preterm low-birth-weight (PLBW) infants are at a higher risk for a number of acute and chronic disorders. Studies point to an association between periodontal infection and increased rates of preterm birth, and pregnant mothers with periodontal diseases are at increased risk of subsequent preterm birth or low birth weight. However, the awareness level of gynecologists about this relationship is unknown. Aims: The aim of the present survey was to assess the awareness about the effects of periodontal disease on pregnancy among practicing gynecologists, and also compare such awareness between gynecologists in two places-Khammam (a district headquarter) and Hyderabad (a state capital). Settings and Design: Random, cross-sectional study in a population of practicing gynecologists from Andhra Pradesh. Materials and Methods: A random study population was selected from the practicing gynecologists in Khammam and Hyderabad. Sixty practicing gynecologists, 30 each in Khammam and Hyderabad, were approached and they consented to join the study. Data were collected in questionnaire format from the subject population. Collected data were statistically analyzed. Chi-square test with Yates correction was used to analyze the data. A " P" value of <0.05 was taken as a significant difference. Results: 73.3% of the gynecologists said that their patients complain of bleeding gums, swellings and mobility. 58.3% of the gynecologists were aware that gum diseases occur at a higher rate in pregnant females. 38.3% of the gynecologists were aware that periodontal diseases can affect the outcome of delivery. No significant difference was found between the awareness levels of gynecologists in Khammam and in Hyderabad. Conclusions: There is a need for interdisciplinary approach for the prevention of PLBW cases by the integration of periodontal care into obstetric management. Effort should be made to increase awareness among the gynecologists.

Exclusive Breastfeeding among Preterm Low Birth Weight Infants at One Month Follow-up after Hospital Discharge.

Background: Establishment and maintenance of breastfeeding in preterm low birth weight (PT LBW) neonates after discharge from hospital is challenging and may be affected by multiple factors. We designed this study to find out the association of these factors with breastfeeding in our population. Objectives: To observe the rate of exclusive breasrfeeding (EBF) among the PT LBW neonates at one month follow up and to identify the factors that are related with the maintenance of EBF. Materials and Methods: This observational study was conducted during the period from July 2009 to October 2011 in Enam Medical College Hospital (EMCH). Preterm infants ≤ 34 wks gestation, stayed in the NICU for >3 days and discharged home were eligible. Mothers were interviewed at one month follow-up after discharge. Infants who were given only breast milk up to 4 weeks were termed as “Exclusively breastfed (EBF)” and who were given formula milk in addition were labeled as “Nonexclusively breastfed (NEBF)”. Baseline information regarding maternal demography, delivery of the baby, feeding during discharge was taken from database of neonatal ward. Results: Among 89 infants, 37 (42%) were female and 52 (58%) were male, including 5 twins. Gestational age ranged from 29 to 34 weeks (mean 32±2), and birth weight ranged from 1100 to 2200 grams (mean 1763±20 g). At one month follow up visit 19% (17/89) were found to be NEBF and 81% were EBF. Factors significantly associated with EBF were shorter duration of hospital stay (p=0.001), method of feeding at discharge (p=0.001), mode of delivery (p=0.004), below average socio-economic status (p=0.03), maternal education (p=0.02), number of antenatal visits (p=0.02) and larger birth weight (p=0.038). Conclusion: A variety of factors may affect EBF in PT LBW babies. Extensive counseling of the mothers during antenatal visits, counseling of the family members regarding the advantages of exclusive breastfeeding is necessary. Support should be provided for the mothers both in the hospital and also outside the hospital for a long period.

The relationship between periodontal diseases and preterm low birth weight / 实用口腔医学杂志

Objective:To assess the periodontal diseases as a possible risk factor for preterm and low birth weight. Methods: A population-based, cross-sectional study was carried out in Hubei. The samples were chosen randomly by the rule of admittance. Socio-demographic information relating to health and maternal habits was collected through a questionnaire. The clinical parameters were debris index-simplified (DI-S), sulcus bleeding index (SBI), probing pocket depth (PD) and clinical attachment loss (CAJ). The birth time and weight were recorded. The result was analyzed with chi-square test and logistic regression analysis.Results: The incidence of preterm low birth weight was 12.3%. The gingivitis and periodontitis were diagnosed in 86.6% and 64.2% of preterm low birth weight cases. The odds ratio of having gingivitis and preterm low birth weight was 1.30(95%confidence interval: 0.53-3.22). The odds ratio of having periodontitis and preterm low birth weight was 2.69(95%confidence interval: 1.37-5.27). Conclusion: The periodontal diseases of pregnancy can be regarded as an important risk factor for preterm low birth weight.

Periodontitis as a Risk Factor for Preterm Low Birth Weight

PURPOSE: 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. The aim of study was to evaluate periodontal diseases as a risk factor for a preterm low birth weight. MATERIALS AND METHODS: A total of 48 mothers, 20 of who had a preterm low birth weight delivery, were examined in the Clinics of Periodontology, Faculty of Dentistry, Cumhuriyet University. The periodontal exams consisted of a full mouth pocket depth, a Loe and Sillness Gingival index score measurements, and a panoramic radiograph analysis. Information on any other factors that may cause a preterm low birth weight was obtained from the family physician. RESULTS: The study results indicated that periodontitis (OR: 3.6 95% CI: 1.06-12.18) together with bacterial vaginosis (OR: 11.57 95% CI: 1.26-105.7) were independent risk factors of a preterm low birth weight. According to the data obtained from this study, the paternal age, tobacco use and the mothers' height were not significant risk factors for a preterm low birth weight. 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.

Relationship between Preterm Low Birth Weight and Periodontal Disease Activity in Pregnancy / 대한치주과학회지

PURPOSE We designed this study for the purpose of determining the relationship between periodontal disease activity and PLBW, using the evaluation of probing pocket depth, loss of attachment, gingival index, gingival crevicular fluid amount and subgingival microflora. METHODS A total of 100 volunteer mothers(mean age 30.44) at the Department of Obstetrics and Gynecology Seoul National University Hospital were selected for this study.Pregnancy outcomes were categorized into cases and controls in two ways. our definition was based on the following; Group 1 : Any PLBW cases Vs. All NBW controls Group 2 : PLBW cases Vs. NBW controls A periodontal exam was performed on the Ramfjord(#16, 21, 24, 36, 41, 44) teeth and Clinical evaluation consisted of probing pocket depth, loss of attachment, gingival index and gingival crevicular fluid amount. Subgingival plaque samples were collected by three sterile #35 paper points. The total number of anaerobic colonies and aerobic bacteria were enumerated after incubation. Antisera to P. gingivalis, P. intermedia, A. actinomycetemcomitans were produced in white rabbits with live whole cells suspensions. The specific fluorescent bacteria obtained by immunofluorescence and total cell counts obtained by dark-field microscopy were counted on four fields. The percent of each specific microorganism in the total cell count was determined. RESULTS Any PLBW and PLBW cases showed significantly greater probing depth and attachment loss than all NBW and NBW controls. Cases group had significantly increased anaerobic bacterial counts compared with control group and no differences in the other microbes. This study confirmed that periodontal disease is a statistically significant risk factor for PLBW by investigating clinical parameters and subgingival plaque analysis.