Pretorius Christopher, Jagatt Anilla, Lamont Ronald F
Department of Obstetrics and Gynecology, Northwick Park and St. Marks Hospitals, Harrow, Middlesex, London, UK.
J Perinat Med. 2007;35(2):93-9. doi: 10.1515/JPM.2007.039.
Spontaneous preterm labor leading to preterm birth is a major cause of perinatal mortality and morbidity worldwide. The etiology of spontaneous preterm labor is multifactoral but there is overwhelming evidence to implicate infection in up to 40% of cases. Historically, this infective link has focused on the associations between abnormal genital tract flora in pregnancy (diagnosed by the presence of bacterial vaginosis) and preterm birth. Recently, another condition related to abnormal flora (periodontal disease) has been linked with preterm birth. There are microbiological similarities between the oral cavity and the female genital tract giving rise to a possible common pathophysiology. This review records the interrelationship between periodontal disease, bacterial vaginosis, and preterm birth. We postulate on the mechanism linking the three conditions, particularly through microbiology and gene-environmental interactions. Periodontal disease and bacterial vaginosis may be risk factors in their own rights or may be interrelated. We speculate on whether periodontitisis a marker for an immune hyperresponse to abnormal flora which in the oral cavity results in periodontitis and in the case of bacterial vaginosis might result in preterm birth. We also postulate on the risk of preterm birth by periodontitis alone, bacterial vaginosis alone, or both.
导致早产的自发性早产是全球围产期死亡率和发病率的主要原因。自发性早产的病因是多因素的，但有压倒性的证据表明，高达40%的病例与感染有关。从历史上看，这种感染关联主要集中在孕期生殖道菌群异常（通过细菌性阴道病的存在来诊断）与早产之间的关联上。最近，另一种与菌群异常相关的疾病（牙周病）也与早产有关。口腔和女性生殖道之间存在微生物学上的相似性，这可能导致共同的病理生理学。本综述记录了牙周病、细菌性阴道病和早产之间的相互关系。我们推测了连接这三种情况的机制，特别是通过微生物学和基因-环境相互作用。牙周病和细菌性阴道病可能本身就是危险因素，也可能相互关联。我们推测牙周炎是否是对异常菌群免疫超反应的一个标志，这种反应在口腔中导致牙周炎，而在细菌性阴道病的情况下可能导致早产。我们还推测了单独由牙周炎、单独由细菌性阴道病或两者共同导致早产的风险。
