Significant association between maternal periodontitis and pre-eclampsia complications - A retrospective case control study

母体牙周炎与先兆子痫并发症之间存在显著关联——一项回顾性病例对照研究

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Abstract

BACKGROUND: Periodontal disease is suspected to play a causal role in adverse pregnancy outcomes like preeclampsia, which is a serious complication of end-stage pregnancy. This study investigated the periodontal status of immediate postpartum women with preeclampsia and compared it with women with normal uncomplicated pregnancy and childbirth. AIMS: The primary aim is to determine the risk of association between maternal periodontal disease and preeclampsia. The secondary outcome is determining whether C-reactive protein (CRP) levels are a potential mediator of this association. MATERIALS AND METHODS: A retrospective case-control study was conducted during a 1-year period among 200 postpartum women with preeclampsia complications and normal gestation on a 1:1 ratio. All the study participants were examined by a qualified periodontist within 48 h postpartum to assess periodontal status and 5 ml of blood drawn for estimation of CRP levels. This correlation was assessed using Spearman's correlation. RESULTS: Statistical analysis by Pearson's Chi-square test and Spearman's rank correlation showed 46% of the study population had chronic periodontitis, out of which 7% had nonsevere preeclampsia without complications and 3% had severe life-threatening preeclampsia with complications (odds ratio 2.49, confidence interval 95% P = 0.001). Furthermore, both the gestational period and mean birth weight decreased with the increasing severity of periodontitis. The increase in CRP levels was positively correlated, as shown by the one-way ANOVA with both periodontitis and preeclampsia, along with gestational period and birth weight of infants. CONCLUSIONS: After adjusting for other risk factors, there is a significant association between maternal periodontitis and preeclampsia complications and a significant correlation between increased CRP levels, increasing severity of periodontitis, and mean birth weight. As periodontitis is a treatable disease. severe adverse pregnancy complication like preeclampsia can be prevented with early diagnosis and management of periodontal health.

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