Elsevier

Obstetrics & Gynecology

Volume 101, Issue 2, February 2003, Pages 227-231
Obstetrics & Gynecology

Original research
Maternal periodontal disease is associated with an increased risk for preeclampsia

https://doi.org/10.1016/S0029-7844(02)02314-1Get rights and content

Abstract

OBJECTIVE:

To determine if maternal periodontal disease is associated with the development of preeclampsia.

METHODS:

A cohort of 1115 healthy pregnant women were enrolled at less than 26 weeks’ gestation and followed until delivery. Maternal demographic and medical data were collected. Periodontal examinations were performed at enrollment and within 48 hours of delivery to determine the presence of severe periodontal disease or periodontal disease progression. Preeclampsia was defined as blood pressure greater than 140/90 on two separate occasions, and at least 1+ proteinuria on catheterized urine specimen. The potential effects of maternal age, race, smoking, gestational age at delivery, and insurance status were analyzed, and adjusted odds ratios for preeclampsia were calculated using multivariable logistic regression.

RESULTS:

During the study period, 763 women delivered live infants and had data available for analysis. Thirty-nine women had preeclampsia. Women were at higher risk for preeclampsia if they had severe periodontal disease at delivery (adjusted odds ratio 2.4, 95% confidence interval 1.1, 5.3), or if they had periodontal disease progression during pregnancy (adjusted odds ratio 2.1, 95% confidence interval 1.0, 4.4).

CONCLUSION:

After adjusting for other risk factors, active maternal periodontal disease during pregnancy is associated with an increased risk for the development of preeclampsia.

Section snippets

Materials and methods

The Oral Conditions and Pregnancy study was a prospective cohort study of the effect of maternal periodontal disease on obstetric outcome conducted by the University of North Carolina Center for Oral and Systemic Disease and the Center for Inflammatory Disorders, in collaboration with Duke University Medical Center. Institutional Review Board approval was obtained to conduct the study, and participants gave written informed consent to participate. Eligible women were identified at their first

Results

During the study period, 5400 women received prenatal care at the study site, and 3456 (64%) of those women were ineligible. Of the 1944 eligible women, 1115 (57%) agreed to participate in the study. Two hundred thirty (20.6%) were excluded from the analysis because they withdrew (109), became ineligible (38), or experienced a spontaneous (72) or elective abortion (11). Of 885 remaining women, 16 (1.9%) experienced either an intrauterine fetal (13) or neonatal (three) demise. The incidence of

Discussion

Maternal clinical periodontal disease at delivery is associated with an increased risk for the development of preeclampsia, independent of the effects of maternal age, race, smoking, gestational age at delivery, and insurance status. In addition, clinically active disease, as measured by presence of periodontal disease progression, is also associated with an increased risk for preeclampsia.

A parallel between the pathophysiologic consequences of preeclampsia and atherosclerotic disease has been

References (21)

There are more references available in the full text version of this article.

Cited by (225)

  • Oral microbiome and pregnancy: A bidirectional relationship

    2021, Journal of Reproductive Immunology
    Citation Excerpt :

    The above study demonstrated that the pregnant women who smoked demonstrated not only enrichment of both methylotrophs and reduction-sensitive species, but also species that ferment mixed acids such as Enterobacteriaceae (Paropkari et al., 2016). Periodontal diseases such as gingivitis and periodontitis are chronic oral infections characterized by local and systemic inflammatory responses and have been associated with adverse outcomes of pregnancy (Boggess et al., 2003; Moore et al., 2004; Farrell et al., 2006). Periodontitis affects about 40 % of pregnant women (Silk et al., 2008; Vamos et al., 2015) and it is associated with a decrease gestational age (Salih et al., 2020).

View all citing articles on Scopus

This study was supported by National Institute of Dental and Craniofacial Research grant no. DE-012453.

View full text