Maternal periodontal disease, systemic inflammation, and risk for preeclampsia

• Published in: American journal of obstetrics and gynecology 2008-04, Vol.198 (4), p.389.e1-389.e5
• Main Authors: Ruma, Michael, MD, Boggess, Kim, MD, Moss, Kevin, Jared, Heather, MS, Murtha, Amy, MD, Beck, James, PhD, Offenbacher, Steven, DDS, PhD
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; C-reactive protein; C-Reactive Protein - analysis; Diagnosis, Oral; Diseases of mother, fetus and pregnancy; Enzyme-Linked Immunosorbent Assay; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Female; Gynecology. Andrology. Obstetrics; Humans; inflammation; Inflammation - blood; Inflammation - complications; Medical sciences; Obstetrics and Gynecology; Otorhinolaryngology. Stomatology; periodontal disease; Periodontal Diseases - blood; Periodontal Diseases - complications; Periodontal Diseases - diagnosis; Pre-Eclampsia - blood; Pre-Eclampsia - etiology; preeclampsia; Pregnancy; Pregnancy. Fetus. Placenta; Risk Factors
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2007.12.002

Objective Maternal periodontal disease, a chronic oral infectious and inflammatory disorder, is associated with an increased risk for preeclampsia. Our objective was to determine the relationship between maternal periodontal disease, maternal systemic inflammation, and the development of preeclampsia. Study Design A secondary analysis of data from the Oral Conditions and Pregnancy Study was performed. A cohort of healthy pregnant women enrolled at less than 26 weeks underwent an oral health examination, serum sampling, and delivery follow-up. Periodontal disease was categorized clinically as present or absent. Maternal serum was assayed for C-reactive protein by high-sensitivity enzyme-linked immunosorbent assay and stratified as elevated (≥ 75th percentile) or not elevated (< 75th percentile). Preeclampsia was defined as blood pressure > 140/90 mmHg and at least 1+ proteinuria on a catheterized urine specimen. Risk ratios (RR) for preeclampsia were calculated, stratified by periodontal disease and C-reactive protein level. Results Thirty-one (4%) of 775 women with complete data developed preeclampsia. Women with CRP ≥ 75th percentile were more likely than those with CRP < 75th percentile to develop preeclampsia (7% vs 3%, P < .03; RR, 95% CI 2.2, 1.1-4.4). Women with periodontal disease and CRP ≥ 75th percentile were at increased risk for preeclampsia (adjusted RR 5.8, 1.2-26.9), compared to women without periodontal disease and either CRP < 75th or ≥ 75th percentile. Conclusion Maternal periodontal disease with systemic inflammation as measured by C-reactive protein is associated with an increased risk for preeclampsia.