Periodontal Disease and Pre-term Pregnancy
The role of periodontitis in general
health is becoming a major interest.
Periodontitis has been linked to heart
disease and featured in a previous article.
Now researchers are finding cause
to believe that periodontitis is also linked to
pre-term pregnancies and low birth
weights. More than 60 % of mortality
among infants without congenital or
anatomic defects is attributable to
pre-term low birth weight (PLBW).
If periodontitis is confirmed as a risk
factor for PLBW, it could provide
new opportunities to reduce infant mortality.
A study by Offenbacher, O'Reilly, and
Katz included 124 women. It showed
that women with periodontitis had
an almost 8-fold greater chance of having
PLBW infants than mothers without
periodontal disease. If other studies
substantiate these findings, they
would suggest that the effects of periodontal
infection on PLBW could be as strong
as the effects of smoking or alcohol
abuse.
How does periodontitis cause these
potentially catastrophic problems? Infection
is a known risk for PLBW. Pre-term
labor appears to be mediated by the
mother's secreted anti-inflammatory
agents such as prostaglandin in response
to an infection. Researchers, Damare,
Wells, and Offenbacher, found a
two-fold increase of prostaglandin
E2 in the gum area around the teeth of
women with PLBW infants as compared
to women with normal birth weight
infants. This suggests a relationship
between prostaglandin concentration in the
gum area and inside the amniotic sac.
The association between periodontitis
and PLBW may suggest an altered
response to infection that places
the person at risk for both conditions. The
studies suggest that not only could
periodontitis be a risk factor for pre-term
delivery, but also an indicator for
the prediction of possible pre-term delivery.
A genetic susceptibility test (PST)
exists to test an individual for the
predisposition to contract periodontitis,
which may in the future prove to be
valuable in predicting the possibility
of pre-term delivery occurring. For now,
prevention and treatment of periodontitis
may provide an opportunity to
decrease PLBW.