Michalowicz Bryan S, Novak M John, Hodges James S, DiAngelis Anthony, Buchanan William, Papapanou Panos N, Mitchell Dennis A, Ferguson James E, Lupo Virginia, Bofill James, Matseoane Stephen, Steffen Michelle, Ebersole Jeffrey L
Department of Developmental and Surgical Sciences, University of Minnesota School of Dentistry, Minneapolis, MN, USA.
J Periodontol. 2009 Nov;80(11):1731-41. doi: 10.1902/jop.2009.090236.
The purposes of this study were to determine: 1) if periodontal treatment in pregnant women before 21 weeks of gestation alters levels of inflammatory mediators in serum; and 2) if changes in these mediators are associated with birth outcomes.
A total of 823 pregnant women with periodontitis were randomly assigned to receive scaling and root planing before 21 weeks of gestation or after delivery. Serum obtained between 13 and 16 weeks, 6 days (study baseline) and 29 to 32 weeks of gestation was analyzed for C-reactive protein; prostaglandin E(2); matrix metalloproteinase-9; fibrinogen; endotoxin; interleukin (IL)-1 beta, -6, and -8, and tumor necrosis factor-alpha. Cox regression, multiple linear regression, and the t, chi(2), and Fisher exact tests were used to examine associations among the biomarkers, periodontal treatment, and gestational age at delivery and birth weight.
A total of 796 women had baseline serum data, and 620 women had baseline and follow-up serum and birth data. Periodontal treatment did not significantly alter the level of any biomarker (P >0.05). Neither baseline levels nor the change from baseline in any biomarker were significantly associated with preterm birth or infant birth weight (P >0.05). In treatment subjects, the change in endotoxin was negatively associated with the change in probing depth (P <0.05).
Non-surgical mechanical periodontal treatment in pregnant women, delivered before 21 weeks of gestation, did not reduce systemic (serum) markers of inflammation. In pregnant women with periodontitis, levels of these markers at 13 to 17 weeks and 29 to 32 weeks of gestation were not associated with infant birth weight or a risk for preterm birth.
本研究的目的是确定：1）妊娠21周前对孕妇进行牙周治疗是否会改变血清中炎症介质的水平；2）这些介质的变化是否与出生结局相关。
总共823名患有牙周炎的孕妇被随机分配在妊娠21周前或分娩后接受龈下刮治和根面平整。分析在妊娠13周零6天（研究基线）和29至32周期间获得的血清中的C反应蛋白、前列腺素E2、基质金属蛋白酶-9、纤维蛋白原、内毒素、白细胞介素（IL）-1β、-6和-8以及肿瘤坏死因子-α。使用Cox回归、多元线性回归以及t检验、卡方检验和Fisher精确检验来检查生物标志物、牙周治疗与分娩时的孕周和出生体重之间的关联。
共有796名女性有基线血清数据，620名女性有基线及随访血清和出生数据。牙周治疗未显著改变任何生物标志物的水平（P>0.05）。任何生物标志物的基线水平或相对于基线的变化均与早产或婴儿出生体重无显著关联（P>0.05）。在治疗组中，内毒素的变化与探诊深度的变化呈负相关（P<0.05）。
在妊娠21周前对孕妇进行非手术机械性牙周治疗并未降低全身（血清）炎症标志物水平。在患有牙周炎的孕妇中，妊娠13至17周和29至32周时这些标志物的水平与婴儿出生体重或早产风险无关。
