Department of Preventive & Community Dentistry, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda.
Department of Biochemistry, Lake Erie College of Osteopathic Medicine, Erie, PA, USA.
J Steroid Biochem Mol Biol. 2018 Jun;180:65-72. doi: 10.1016/j.jsbmb.2018.01.010. Epub 2018 Jan 16.
Studies have shown a relationship between maternal periodontal diseases (PDs) and premature delivery. PDs are commonly encountered oral diseases which cause progressive damage to the periodontal ligament and alveolar bones, leading to loss of teeth and oral disabilities. PDs also adversely affect general health by worsening of cardiovascular and metabolic diseases. Moreover, maternal PDs are thought to be related to increasing the frequency of preterm-birth with low birth weight (PBLBW) in new-borns. Prematurity and immaturity are the leading causes of prenatal and infant mortality and is a major public health problem around the world. Inflamed periodontal tissues generate significantly high levels of proinflammatory cytokines that may have systemic effects on the host mother and the fetus. In addition, the bacteria that cause PDs produce endotoxins which can harm the fetus. Furthermore, studies have shown that microorganisms causing PDs can get access to the bloodstream, invading uterine tissues, to induce PBLBW. Another likely mechanism that connects PDs with adverse pregnancy outcome is maternal vitamin D status. A role of inadequate vitamin D status in the genesis of PDs has been reported. Administration of vitamin D supplementation during pregnancy could reduce the risk of maternal infections and adverse pregnancy outcomes. As maternal PDs are significant risk factors for adverse pregnancy outcome, preventive antenatal care for pregnant women in collaboration with the obstetric and dental professions are required.
研究表明，母体牙周病（PDs）与早产之间存在关联。PDs 是常见的口腔疾病，会导致牙周韧带和牙槽骨的进行性损伤，导致牙齿脱落和口腔功能障碍。PDs 还通过加重心血管和代谢疾病对一般健康产生不利影响。此外，人们认为母体 PDs 与新生儿低出生体重（PBLBW）的早产频率增加有关。早产和不成熟是产前和婴儿死亡的主要原因，也是全球的一个主要公共卫生问题。发炎的牙周组织会产生大量的促炎细胞因子，这些细胞因子可能对宿主母亲和胎儿产生全身影响。此外，引起 PDs 的细菌会产生内毒素，从而损害胎儿。此外，研究表明，引起 PDs 的微生物可以进入血液，侵犯子宫组织，导致 PBLBW。将 PDs 与不良妊娠结局联系起来的另一个可能机制是母体维生素 D 状况。据报道，维生素 D 状态不足在 PDs 的发病机制中起作用。在怀孕期间补充维生素 D 可以降低母体感染和不良妊娠结局的风险。由于母体 PDs 是不良妊娠结局的重要危险因素，因此需要妇产科和牙科专业人员合作，为孕妇提供预防性产前保健。
