León Rubén, Silva Nora, Ovalle Alfredo, Chaparro Alejandra, Ahumada Alexis, Gajardo Marta, Martinez Maria, Gamonal Jorge
Biochemistry Laboratory, Faculty of Dentistry, University of Chile, Santiago, Chile.
J Periodontol. 2007 Jul;78(7):1249-55. doi: 10.1902/jop.2007.060368.
Epidemiologic and randomized controlled studies have shown that periodontal diseases may be associated with preterm labor and delivery of infants with low birth weights. The purpose of the present study was to determine the presence of microbial invasion of the amniotic cavity by periodontopathic bacteria in pregnant women with a diagnosis of threatened premature labor.
A periodontal examination and collection of amniotic fluid and subgingival plaque samples were performed on women identified as having threatened premature labor (preterm premature rupture of membranes without clinical infection or labor and preterm labor with intact membranes) and a gestational age ranging between 24 and 34 weeks. Samples collected from amniotic fluid and from the four deepest periodontal pockets in each patient were pooled in prereduced transport fluid and cultured. Porphyromonas gingivalis was identified primarily by colony morphology under stereoscopic microscope and rapid biochemical tests. Amniotic fluid or plaque samples were homogenized, DNA was extracted, and polymerase chain reaction (PCR) amplification of 16S rRNA with specific and universal primers was carried out.
Twenty-six women with threatened premature labor were included: eight with preterm premature rupture of membranes and 18 with preterm labor with intact membranes. Eight women presented with gingivitis, 12 with chronic periodontitis, and six without periodontal disease. Microbial invasion of the amniotic cavity as detected by P. gingivalis PCR was 30.8% (eight of 26 patients). In these eight patients, P. gingivalis was present in both the subgingival samples and the respective amniotic fluid sample.
The presence of microbial invasion of the amniotic cavity by P. gingivalis could indicate a role for periodontal pathogenic bacteria in pregnant women with a diagnosis of threatened premature labor.
流行病学和随机对照研究表明，牙周疾病可能与早产和低体重儿的分娩有关。本研究的目的是确定诊断为先兆早产的孕妇羊膜腔内是否存在牙周病原菌的微生物入侵。
对诊断为先兆早产（胎膜早破但无临床感染或临产以及胎膜完整的早产）且孕周在24至34周之间的女性进行牙周检查，并采集羊水和龈下菌斑样本。将从羊水和每位患者四个最深牙周袋中采集的样本汇集于预还原运输液中进行培养。牙龈卟啉单胞菌主要通过立体显微镜下的菌落形态和快速生化试验进行鉴定。将羊水或菌斑样本匀浆，提取DNA，并使用特异性和通用引物对16S rRNA进行聚合酶链反应（PCR）扩增。
纳入了26例先兆早产女性：8例胎膜早破，18例胎膜完整的早产。8例患有牙龈炎，12例患有慢性牙周炎，6例无牙周疾病。通过牙龈卟啉单胞菌PCR检测到羊膜腔微生物入侵的比例为30.8%（26例患者中的8例）。在这8例患者中，牙龈卟啉单胞菌同时存在于龈下样本和相应的羊水样本中。
牙龈卟啉单胞菌对羊膜腔的微生物入侵可能表明牙周病原菌在诊断为先兆早产的孕妇中发挥了作用。
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