Relationship of Chronic Periodontitis and Plasma C - Reactive Protein during Pregnancy


Affiliations

  • Sri Guru Ram Das Institute of Dental Sciences and Research, Department of Periodontology and Oral Implantology, Amritsar, Punjab, India
  • Guru Nanak Dev Hospital, Amritsar, Punjab, India

Abstract

Background: Maternal periodontal disease is a chronic oral infection with local and systemic inflammatory responses and may be associated with adverse pregnancy outcomes. Elevated levels of C-reactive protein has been linked to adverse pregnancy outcomes in maternal periodontal disease.

Objectives: To assess plasma C-reactive protein levels in pregnant women with chronic periodontitis and in periodontal health and to compare the incidence of preterm delivery in pregnant women having chronic periodontitis and in periodontal health.

Materials and Methods: A total of 122 pregnant women aged 18 years and above with gestational age < 26 weeks were recruited and divided into two equal groups (control group, study group) of 61 each. Blood samples were taken from both the groups to determine the serum C-reactive protein.

Results: The mean value of C-reactive protein levels in subjects having chronic periodontitis was higher compared to control group i.e., 2.462 ± 0.318 compared to 1.307 ± 0.361 (P<0.001). The incidence of preterm delivery (<37 weeks) was 82% in the chronic periodontitis group (study group) compared to 3.3% in the control group (P<0.001). The incidence of low birth weight (<2500g) was 45.9% in chronic periodontitis (study group) compared to 14.8% in the control group (p<0.001).

Conclusion: The findings from the study suggest that periodontal disease in pregnant women is associated with increased C-reactive protein levels in pregnancy. Incidence of preterm delivery and low birth weight infants is higher in pregnant women with chronic periodontitis compared to healthy controls.


Keywords

C-Reactive Protein, Preterm Birth, Low Birth Weight.

Subject Discipline

Dentistry

Full Text:

References

Page RC. The role of inflammatory mediators in the pathogenesis of periodontal disease. J Periodontal Res 1991; 26:230-42.

Craig RG, Yip JK, So MK, Boylan RJ, Socransky SS, Haffajee AD. Relationship of destructive periodontal disease to the acute-phase response. J Periodontol 2003; 74:1007-16.

Pepys MB, Baltz ML. Acute phase proteins with special reference to Creactive protein and related proteins (pentaxins) and serum amyloid A protein. Adv Immunol 1983; 34:141-212.

Pitiphat W, Gillman MW, Joshipura KJ, Williams PL, Douglass CW, Rich-Edwards JW. Plasma C-reactive protein in early pregnancy and preterm delivery. Am J Epidemiol 2005; 162:1108-13.

Teran E, Escudero C, Moya W, Flores M, Vallance P, Lopez Jaramillo P. Elevated C-reactive protein and pro-inflammatory cytokinesin Andean women with preeclampsia. Int J Gynaecol Obstet 2001; 75:243-9.

Tjoa ML, Van Vugt JM, Go AT, Blankenstein MA, Oudejans CB, Van Wijk IJ. Elevated C-reactive protein levels during first trimester of pregnancy are indicative of preeclampsia and intrauterine growth restriction. J Reprod Immunol 2003; 59:29-37.

Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G, et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 1996; 67:1103-13.

Dasanayake AP. Poor periodontal health of the pregnant woman as a risk factor for low birth weight. Ann Periodontol 1998; 3:206-12.

Jeffcoat MK, Geurs NC, Reddy MS, Cliver S, Goldenberg RL, Hauth JC. Periodontal infection and preterm birth: Results of a prospective study. J Am Dent Assoc 2001; 132:875-80.

Cermak J, Key NS, Bach RR, Balla J, Jacob HS, Vercellotti GM. C-reactive protein induces human peripheral blood monocytes to synthesize tissue factor. Blood 1993; 82:513-20.

Harald Loe. The gingival index, the laque index and the retention index systems. Journal of Periodontology 1967; 38:610-16.

Belkys C Romero, Claudio S Chiquito, Luis E Elejalde, Cecilia B Bernadorni. Relationship between periodontal disease in pregnant women and the nutritional condition of their newborns. J Periodontol 2002; 73:1177-83.

Waranuch Pitiphat, Kaumudi J Joshipura, Janet W Rich-Edwards, Paige L Williams, Chester W Douglass, Matthew W Gillmani. Periodontitis and Plasma C Reactive Protein during Pregnancy. J Periodontol 2006; 77:821-5.

Beck J, Garcia R, Heiss G, Vokonas PS, Offenbacher S. Periodontal disease and cardiovascular disease. J Periodontal 1996; 67:1123-37.

Noack B, Genco RJ, Trevisan M, Grossi S. Periodontal infections contribute to elevated systemic C-reactive protein level. J Periodontol 2001; 72:1221-7.

Hvilsom GB, Thorsen P, Jeune B, Bakketeig LS. C-reactive protein: A serological marker for preterm delivery? Acta Obstet Gynecol Scand 2002; 81:4248.

Lopez NJ, Smith PC, Gutierrez. Higher risk of preterm birth and low birth weight in women with periodontal disease. J Dent Res 2002; 81:58-63.

Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med 1999; 40:448-54.


Refbacks

  • There are currently no refbacks.