Numerous studies have documented an association between maternal periodontal disease and preterm birth and low birth weight. There are several potential.

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Presentation transcript:

Numerous studies have documented an association between maternal periodontal disease and preterm birth and low birth weight. There are several potential explanations for this association. Periodontal disease may have direct effects on the uterus through bacteremia causing direct infection of the chorioamnion. However, it is more likely that an indirect mechanism mediated by a systemic inflammatory response occurs. Bacteremia: Direct Mechanism Periodontal infection in the mouth may have direct effects on the uterus through bacteremia causing direct infection on the chorioamnion. However, bacteria have not been found in amniotic fluid cultures. Systemic Inflammatory Response: Indirect Mechanism It is more likely that preterm birth results from a systemic inflammatory response to periodontal infection that increases prostaglandins and interleukins and affect labor initiation. Inflammatory response may lead to placental blood flow restriction, placental necrosis, and consequent low birth weight. A similar mechanism has been proposed to explain the association seen between periodontitis and increased rates of heart disease and diabetes. References Boggess KA, Edelstein BL. Oral health in women during preconception and pregnancy: Implications for birth outcomes and infant oral health. Matern Child Health J 2006;10:S169-174. Dörtbudak O, Eberhardt R, Ulm M, Persson GR. Periodontitis, a marker of risk in pregnancy for preterm birth. J Clin Periodontol 2005;32:45-52. Goepfert AR, Jeffcoat MK, Andrews WW, Faye-Petersen O, Cliver SP, Goldenberg RL, et al. Periodontal Disease and Upper Genital Tract Inflammation in Early Spontaneous Preterm Birth. Obstetrics & Gynecology 2004;104:777-783. Xiong X, Buekens P, Fraser WD, Beck J, Offenbacher S. Periodontal disease and adverse pregnancy outcomes: A systematic review. BJOG 2006;113:135-143.