Journal of The Korean Society of Integrative Medicine (대한통합의학회지)

Korean Society of Integrative Medicine (대한통합의학회)
권호 표지
DOI QR코드

DOI QR Code

Association between Periodontitis and Preeclampsia: a Systematic Review

임신기 치주질환과 자간전증 발생간의 연관성

  • Ha, Jungeun (Dept. of Dental Hygiene, Division of Health Science, Baeksoek University)
  • 하정은 (백석대학교 보건학부 치위생학과)
  • Received : 2017.08.14
  • Accepted : 2017.10.11
  • Published : 2018.03.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose : Preeclampsia(PE) is a pregnancy-specific disease which is characterized by hypertension and proteinuria. This disease occurs in about 2-8 % of pregnancies in developing countries and remains among the major causes of maternal and neonatal mortality and morbidity throughout the world. Although the causes of PE are not fully understood, the infection has been considered as the main risk factor for this diseases. Periodontal disease may provide a chronic burden of endotoxin and inflammatory cytokines and the disease has been considered as risk factors of systemic illnesses including cardiovascular disease, atherosclerosis, and cerebrovascular ischemia. So, studies performed over the last 15 years have suggested that periodontal disease may be associated with adverse pregnancy outcomes such as PE. However, this association has not been found in all populations. The aim of this review article was to evaluate whether periodontal status and the presence of specific periodontal pathogens may influence the incidence of PE. Methods : Many research articles searched at the electronic databases(MEDLINE; 2000 to July 2017) including search term as periodontal disease and preeclampsia. Result : There were 10 case-control studies and 5 cohort studies meeting our inclusion criteria. The results showed that maternal periodontitis (adjusted odds ratio: 1.5 to 9.3) was associated with preeclampsia in 15 epidemiological studies. Conclusion : It is clear that maternal periodontitis is a risk factor associated with preeclampsia, emphasizing the importance of periodontal care in prenatal programs.

Keywords

References

  1. Boggess KA, Lieff S, Murtha AP, et al(2003). Maternal periodontal disease is associated with an increased risk for preeclampsia. Obstet Gynecol, 101(2), 227-231. https://doi.org/10.1016/S0029-7844(02)02314-1
  2. Buduneli N, Becerik S, Buduneli E, et al(2010). Gingival status, crevicular fluid tissue-type plasminogen activator, plasminogen activator inhibitor-2 levels in pregnancy versus post-partum. Aust Dent J, 55(3), 292–297. https://doi.org/10.1111/j.1834-7819.2010.01237.x
  3. Canakci V, Canakci CF, Canakci H, et al(2004). Periodontal disease as a risk factor for pre-eclampsia: a case control study. Aust N Z J Obstet Gynecol, 44(6), 568-573. https://doi.org/10.1111/j.1479-828X.2004.00323.x
  4. Cohen DW, Shapiro J, Friedman L, et al(1971). A longitudinal investigation of the periodontal changes during pregnancy and fifteen months post-partum. II. J Periodontol, 42(10), 653–657. https://doi.org/10.1902/jop.1971.42.10.653
  5. Conde-Agudelo A, Villar J, Lindheimer M(2008). Maternal infection and risk of preeclampsia: systematic review and meta-analysis. Am J Obstet Gynecol, 198(1), 7-22. https://doi.org/10.1016/j.ajog.2007.07.040
  6. Contreras A, Herrera JA, Soto JE, et al(2006). Periodontitis is associated with preeclampsia in pregnant women. J Periodontol, 77(2), 182-188. https://doi.org/10.1902/jop.2006.050020
  7. Cota LO, Guimaraes AN, Costa JE, et al(2006). Association between maternal periodontitis and an increased risk of preeclampsia. J Periodontol, 77(12), 2063-2069. https://doi.org/10.1902/jop.2006.060061
  8. Desai K, Desai P, Duseja S, et al(2015). Significance of maternal periodontal health in preeclampsia. J Int Soc Prev Community Dent, 5(2), 103-107. https://doi.org/10.4103/2231-0762.155734
  9. Gursoy M, Pajukanta R, Sorsa T, et al(2008). Clinical changes in periodontium during pregnancy and post-partum. J Clin Periodontol, 35(7), 576–583. https://doi.org/10.1111/j.1600-051X.2008.01236.x
  10. Ha JE, Oh KJ, Yang HJ, et al(2011). Oral health behaviors, periodontal disease, and pathogens in preeclampsia: a case-control study in Korea. J Periodontol, 82(12), 1685-1692. https://doi.org/10.1902/jop.2011.110035
  11. Ha JE, Jun JK, Ko HJ, et al(2014). Association between periodontitis and preeclampsia in never-smokers: a prospective study. J Clin Periodontol, 41(9), 869-874. https://doi.org/10.1111/jcpe.12281
  12. Haram K, Mortensen JH, Wollen AL(2003). Preterm delivery: an overview. Acta Obstet Gynecol Scand, 82(8), 687-704. https://doi.org/10.1034/j.1600-0412.2003.00218.x
  13. Hung HC, Willet W, Merchant A, et al(2003) Oral health and peripheral arterial disease. Circulation, 107(8), 1152–1157. https://doi.org/10.1161/01.CIR.0000051456.68470.C8
  14. Khader Y, Khassawneh B, Obeidat B, et al(2008). Periodontal status of patients with metabolic syndrome compared to those without metabolic syndrome. J Periodontol, 79(11), 2048-2053. https://doi.org/10.1902/jop.2008.080022
  15. Khader Y, Jibreal M, Al-Omiri M, et al(2006). Lack of association between periodontal parameters and preeclampsia. J Periodontol, 77(10), 1681-1687. https://doi.org/10.1902/jop.2006.050463
  16. Kunnen A, Blaauw J, van Doormaal JJ, et al(2007). Women with a recent history of early-onset pre-eclampsia have a worse periodontal condition. J Clin Periodontol, 34(3), 202-207. https://doi.org/10.1111/j.1600-051X.2006.01036.x
  17. Kornman KS, Loesche WJ(1980). The subgingival microbial flora during pregnancy. J Periodontal Res, 15(2), 111–122. https://doi.org/10.1111/j.1600-0765.1980.tb00265.x
  18. Kumar A, Basra M, Begum N, et al(2013). Association of maternal periodontal health with adverse pregnancy outcome. J Obstet Gynecol Res, 39(1), 40-45. https://doi.org/10.1111/j.1447-0756.2012.01957.x
  19. Lam C, Lim KH, Karumanchi SA(2005). Circulating angiogenic factors in the pathogenesis and prediction of preeclampsia. Hypertension, 46(5), 1077-1085. https://doi.org/10.1161/01.HYP.0000187899.34379.b0
  20. Lee HJ, Ha JE, Bae KH(2016). Synergistic effect of maternal obesity and periodontitis on preterm birth in women with pre-eclampsia: a prospective study. J Clin Periodontol, 43(8), 646-51. https://doi.org/10.1111/jcpe.12574
  21. Lockwood CJ, Huang SJ, Krikun G, et al(2011). Decidual hemostasis, inflammation, and angiogenesis in pre-eclampsia. Semin Thromb Hemost, 37(2), 158-164. https://doi.org/10.1055/s-0030-1270344
  22. Madianos PN, Bobetsis YA, Offenbacher S(2013). Adverse pregnancy outcomes (APOs) and periodontal disease: pathogenic mechanisms. J Clin Periodontol, 40(Suppl 4), 170S-180S. https://doi.org/10.1111/jcpe.12082
  23. Mealey BL, Oates TW(2006). Diabetes mellitus and periodontal diseases. J Periodontol, 77(8), 1289-1303. https://doi.org/10.1902/jop.2006.050459
  24. Miller WD(1891). The human mouth as a focus of infection. Dental Cosmos, 138(3546), 340-342.
  25. Moura da Silva G, Coutinho SB, Piscoya MD, et al(2012). Periodontitis as a risk factor for preeclampsia. J Periodontol, 83(11), 1388-1396. https://doi.org/10.1902/jop.2012.110256
  26. Odegard RA, Nilsen ST, Austgulen R(2000). Preeclampsia and fetal growth. Obstet Gynecol, 96(6), 950-955. https://doi.org/10.1016/S0029-7844(00)01040-1
  27. Pihlstrom BL, Michalowicz BS, Johnson NW(2005) Periodontal diseases. Lancet, 366(9499), 1809-1820. https://doi.org/10.1016/S0140-6736(05)67728-8
  28. Seraphim AP, Chiba FY, Pereira RF, et al(2016). Relationship among periodontal disease, insulin resistance, salivary cortisol, and stress levels during pregnancy. Braz Dent J, 27(2), 123-127. https://doi.org/10.1590/0103-6440201600596
  29. Seymour GJ, Ford PJ, Cullinan MP, et al(2007). Relationship between periodontal infections and systemic disease. Clin Microbiol Infect, 13(1), 3-10. https://doi.org/10.1111/j.1469-0691.2007.01798.x
  30. Shetty M, Shetty PK, Ramesh A, et al(2010). Periodontal disease in pregnancy is a risk factor for preeclampsia. Acta Obstet Gynecol Scand, 89(5), 718-721. https://doi.org/10.3109/00016341003623738
  31. Siqueira FM, Cota LO, Costa JE, et al(2008). Maternal periodontitis as a potential risk variable for preeclampsia: a case-control study. J Periodontol, 79(2), 207-215. https://doi.org/10.1902/jop.2008.070174
  32. Taghzouti N, Xiong X, Gornitsky M, et al(2012). Periodontal disease is not associated with preeclampsia in Canadian pregnant women. J Periodontol, 83(7), 871-877. https://doi.org/10.1902/jop.2011.110342
  33. Villar J, Say L, Shennan A, et al(2004). Methodological and technical issues related to the diagnosis, screening, prevention, and treatment of pre-eclampsia and eclampsia. Int J Gynecol Obstet, 85(suppl 1), 28S-41S. https://doi.org/10.1016/j.ijgo.2004.03.009
  34. Walker JJ(2000). Pre-eclampsia. Lancet, 356(9237), 1260-1265. https://doi.org/10.1016/S0140-6736(00)02800-2
  35. Wang A, Rana S, Karumanchi SA(2009). Preeclampsia: the role of angiogenic factors in its pathogenesis. Physiology, 24(1), 147-158. https://doi.org/10.1152/physiol.00043.2008
  36. Xie Y, Xiong X, Elkind-Hirsch KE, et al(2013). Change of periodontal disease status during and after pregnancy. J Periodontol, 84(6), 725-731. https://doi.org/10.1902/jop.2012.120235