Pathways and Mechanisms of Periodontitis Contributing to Adverse Pregnancy Outcomes
Abstract
Periodontitis is a chronic oral inflammatory disease with a high incidence in the global population. Periodontal pathogens can colonize and infect multiple human tissues and organs through blood transmission, which is an important risk factor of many systemic diseases. Recently, the correlation between periodontitis and adverse pregnancy outcomes (APOs) has attracted growing research interest. Herein, we systematically reviewed the research progress in the relationship between periodontitis and APOs and summarized reported findings on the pathways and mechanisms by which periodontitis contributes to APOs. We also clarified that intrauterine infection caused by oral pathogens transmitted through blood is an important pathway by which periodontitis interferes with pregnancy. In addition, further research focused on the discovery of more APOs-related oral pathogenic bacteria and their virulence factors, analysis of the interaction between pathogenic bacteria and placental tissue, and pathogenic pathways of oral bacterial invasion of the fetus will promote thorough analysis of the specific molecular mechanism of how periodontitis affects APOs. Furthermore, the validation of the results of human population-based studies through animal/cell experiments and the translation into effective intervention strategies are of great clinical significance to the prevention and control of the occurrence and development of APOs.
Keywords: Periodontitis, Adverse pregnancy outcome, Periodontal pathogens, Intrauterine infection, Fusobacterium nucleatum
Full Text:
PDFReferences
DAALDEROP L A, WIELAND B V, TOMSIN K, et al. Periodontal disease and pregnancy outcomes: overview of systematic reviews. JDR Clin Trans Res,2018,3(1): 10–27. doi: 10.1177/2380084417731097.
PENG X, CHENG L, YOU Y, et al. Oral microbiota in human systematic diseases. Int J Oral Sci,2022,14(1): 14. doi: 10.1038/s41368-022-00163-7.
OFFENBACHER S, KATZ V, FERTIK G, et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol,1996, 67(Suppl 10S): 1103–1113. doi: 10.1902/jop.1996.67.10s.1103.
BOGGESS K A, Society for Maternal-Fetal Medicine Publications Committee. Maternal oral health in pregnancy. Obstet Gynecol,2008, 111(4): 976–986. doi: 10.1097/AOG.0b013e31816a49d3.
GUNCU G N, TOZUM T F, CAGLAYAN F. Effects of endogenous sex hormones on the periodontium-review of literature. Aust Dent J,2005, 50(3): 138–145. doi: 10.1111/j.1834-7819.2005.tb00352.x.
Committee Opinion No. 569: oral health care during pregnancy and through the lifespan. Obstet Gynecol, 2012, 122(2pt1): 417−422. doi: 10. 1097/01.AOG.0000433007.16843.10.
WU M, CHEN S W, JIANG S Y. Relationship between gingival inflammation and pregnancy. Mediators Inflamm,2015,2015: 623427. doi: 10.1155/2015/623427.
RAJU K, BERENS L. Periodontology and pregnancy: an overview of biomedical and epidemiological evidence. Periodontol 2000,2021,87(1): 132–142. doi: 10.1111/prd.12394.
SLOTS J. Periodontitis: facts, fallacies and the future. Periodontol 2000, 2017,75(1): 7–23. doi: 10.1111/prd.12221.
HAJISHENGALLIS G, LAMONT R J. Beyond the red complex and into more complexity: the polymicrobial synergy and dysbiosis (PSD) model of periodontal disease etiology. Mol Oral Microbiol,2012,27(6): 409–419. doi: 10.1111/j.2041-1014.2012.00663.x.
SOCRANSKY S S, HAFFAJEE A D, CUGINI M A, et al. Microbial complexes in subgingival plaque. J Clin Periodontol,1998,25(2): 134–144. doi: 10.1111/j.1600-051x.1998.tb02419.x.
CARRILLO-De-ALBORNOZ A, FIGUERO E, HERRERA D, et al. Gingival changes during pregnancy: Ⅱ. Influence of hormonal variations on the subgingival biofilm. J Clin Periodontol,2010,37(3): 230–240. doi: 10.1111/j.1600-051X.2009.01514.x.
EMMATTY R, MATHEW J J, KURUVILLA J. Comparative evaluation of subgingival plaque microflora in pregnant and non-pregnant women: a clinical and microbiologic study. J Indian Soc Periodontol,2013,17(1): 47–51. doi: 10.4103/0972-124X.107474.
PIHLSTROM B L, MICHALOWICZ B S, JOHNSON N W. Periodontal diseases. Lancet,2005,366: 1809–1820. doi: 10.1016/S0140-6736(05) 67728-8.
MANAU C, ECHEVERRIA A, AGUEDA A, et al. Periodontal disease definition may determine the association between periodontitis and pregnancy outcomes. J Clin Periodontol,2008,35(5): 385–397. doi: 10. 1111/j.1600-051X.2008.01222.x.
AMAR S, CHUNG K M. Influence of hormonal variation on the periodontium in women. Periodontology 2000,1994,6: 79–87. doi: 10. 1111/j.1600-0757.1994.tb00028.x.
SYKES L, MACINTYRE D A, YAP X J, et al. The Th1: Th2 dichotomy of pregnancy and preterm labour. Mediators Inflamm,2012,2012: 967629. doi: 10.1155/2012/967629.
La ROCCA C, CARBONE F, LONGOBARDI S, et al. The immunology of pregnancy: regulatory T cells control maternal immune tolerance toward the fetus. Immunol Lett,2014,162(1 Pt A): 41–48. doi: 10.1016/j. imlet.2014.06.013.
VANNUCCINI S, BOCCHI C, SEVERI F M, et al. Endocrinology of human parturition. Ann Endocrinol (Paris),2016,77(2): 105–113. doi: 10.1016/j.ando.2016.04.025.
GOLDENBERG R L, HAUTH J C, ANDREWS W W. Intrauterine infection and preterm delivery. New Engl J M,2000,342(20): 1500–1507. doi: 10.1056/NEJM200005183422007.
LAWN J E, BLENCOWE H, WAISWA P, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet,2016,387(10018): 587–603. doi: 10.1016/S0140-6736(15)00837-5.
BAUD O, EMILIE D, PELLETIER E, et al. Amniotic fluid concentrations of interleukin-1beta, interleukin-6 and TNF-alpha in chorioamnionitis before 32 weeks of gestation: histological associations and neonatal outcome. Br J Obstet Gynaecol,1999,106(1): 72–77. doi: 10. 1111/j.1471-0528.1999.tb08088.x.
Von MINCKWITZ G, GRISCHKE E M, SCHWAB S, et al. Predictive value of serum interleukin-6 and -8 levels in preterm labor or rupture of the membranes. Acta Obstet Gynecol Scand,2000,79(8): 667–672. doi: 10.1034/j.1600-0412.2000.079008667.x.
Refbacks
- There are currently no refbacks.