Huang Zhen, DerGarabedian Brett P, He Lu, Sha Yueqin, Chen Zhibin, Kang Jun, Cai Yu, Gao Ping
Oral Health Prev Dent. 2020 Oct 2;18(4):855-864. doi: 10.3290/j.ohpd.a45355.
This study examines the difference in the oral microbiome during pregnancy and the postpartum period of a Chinese population, with the focus on P. gingivalis, P. intermedia and P. nigrescens and their shift during pregnancy, in order to understand the host-microbe relationship in maintaining homeostasis during pregnancy.
This cross-sectional study was carried out in a total of 117 women who underwent prenatal or regular examinations at four public hospitals, including 84 pregnant and 33 postpartum women. Women in the postpartum group were examined within 0.5-1 year after delivery, while the pregnant group was divided into early pregnancy (0-13 weeks), middle pregnancy (14-27 weeks), and late pregnancy (28-39 weeks) according to gestational age. Sociodemographic parameters were self-reported by recruited women. The study required evaluations of probing depth (PD), bleeding index (BI), clinical attachment loss (CAL), and plaque index (PlI). Unstimulated whole saliva samples were collected for the detection of P. gingivalis, P. intermedia, and P. nigrescens. Bacterial populations were evaluated using 16S rRNA-based polymerase chain reaction.
P. nigrescens exhibited higher prevalence in the pregnant group compared to the postpartum group (45.67% vs 12.10%, p < 0.01). P. nigrescens was more frequently detected in late than in early pregnancy (57.7% vs 48.3%, p < 0.05) and middle pregnancy (57.7% vs 31.0%, p < 0.01). Initially high prevalence of P. gingivalis in early pregnancy wanes in middle and late pregnancy (69.0%, 44.8%, 38.5%). However, the prevalence of P. gingivalis in the postpartum group (81.8%) exceeds all of the pregnant groups (p < 0.01). The change in the prevalence of P. intermedia among different groups was not statistically significant. The percentages of bleeding on probing (BOP%) sites and PD ≥4 mm sites in the postpartum group were statistically significantly higher when compared with each of the pregnant groups (p < 0.01). During pregnancy, women experienced elevated PlI, BI, PD, and BOP% (p < 0.05). The proportions of subjects in the pregnant group who agreed with the statements 'Gingival bleeding is normal', 'Can't brush teeth within 1st month postpartum', 'It's unnecessary to see a dentist if not uncomfortable' were 39.3%, 28.6%, and 35.7%, respectively.
P. nigrescens is more related than P. gingivalis to pregnancy status. The periodontal status of Chinese women progressively deteriorates during pregnancy and persists into the postpartum period, which may result from lack of dental care knowledge.
本研究调查中国人群孕期和产后口腔微生物群的差异，重点关注牙龈卟啉单胞菌、中间普氏菌和变黑普氏菌及其在孕期的变化，以了解孕期维持体内稳态过程中的宿主-微生物关系。
本横断面研究共纳入117名在四家公立医院接受产前检查或常规检查的女性，其中84名孕妇和33名产后女性。产后组女性在分娩后0.5 - 1年内接受检查，而孕妇组根据孕周分为早孕（0 - 13周）、中孕（14 - 27周）和晚孕（28 - 39周）。社会人口统计学参数由招募的女性自行报告。该研究需要评估探诊深度（PD）、出血指数（BI）、临床附着丧失（CAL）和菌斑指数（PlI）。收集未刺激的全唾液样本以检测牙龈卟啉单胞菌、中间普氏菌和变黑普氏菌。使用基于16S rRNA的聚合酶链反应评估细菌种群。
与产后组相比，孕妇组中变黑普氏菌的患病率更高（45.67%对12.10%，p < 0.01）。晚孕期比早孕期（57.7%对48.3%，p < 0.05）和中孕期（57.7%对31.0%，p < 0.01）更频繁检测到变黑普氏菌。早孕期牙龈卟啉单胞菌最初的高患病率在中孕期和晚孕期下降（69.0%、44.8%、38.5%）。然而，产后组中牙龈卟啉单胞菌的患病率（81.8%）超过所有孕妇组（p < 0.01）。不同组间中间普氏菌患病率的变化无统计学意义。与各孕妇组相比，产后组探诊出血（BOP%）部位和PD≥4 mm部位的百分比在统计学上显著更高（p < 0.01）。孕期女性的PlI、BI、PD和BOP%升高（p < 0.05）。孕妇组中同意“牙龈出血正常”、“产后第1个月内不能刷牙”、“如果没有不适就没必要看牙医”这些说法的受试者比例分别为39.3%、28.6%和35.7%。
与牙龈卟啉单胞菌相比，变黑普氏菌与妊娠状态的关系更大。中国女性的牙周状况在孕期逐渐恶化并持续到产后，这可能是由于缺乏口腔护理知识所致。
