Albers Daniela, Bendek María José, Hernández Marcela, Prieto Diego, Rojas Carolina, Mizgier María Luisa, Hernández Patricia, Illanes Sebastián E, Chaparro Alejandra
Department of Oral Pathology and Conservative Dentistry, Periodontics, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile.
Center for Biomedical Research and Innovation (CIIB), Universidad de Los Andes, Santiago, Chile.
Front Dent Med. 2025 Jul 29;6:1625995. doi: 10.3389/fdmed.2025.1625995. eCollection 2025.
Emerging evidence suggests that abnormal angiogenesis and imbalanced angiogenic factors may contribute to the development of spontaneous preterm birth (sPTB). In addition, pregnancy-related angiogenic changes and increased vascular permeability in periodontal tissues could amplify periodontal inflammation under hormonal influence.
This study aimed to evaluate the association between gingival crevicular fluid (GCF) levels of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) and sPTB risk and to assess their correlation with periodontal disease severity during early pregnancy.
A prospective cohort study was conducted involving 348 pregnant women, with obstetric, clinical, and periodontal parameter assessments performed at 11-14 weeks of gestation, including probing depth (PD), clinical attachment loss (CAL), bleeding on probing (BOP), periodontal inflamed surface area (PISA), and plaque index score (PI). GCF samples were collected, and PlGF and sFlt-1 levels were measured using Magpix-Luminex® multiplex technology.
sPTB occurred in 3.45% ( = 12) of the participants. The women who had a sPTB had a significantly higher GCF PlGF/sFlt-1 ratio ( = 0.017) and lower sFlt-1 levels ( = 0.003) compared to those who had term pregnancies. A multivariate regression model combining the PlGF/sFlt-1 ratio, PI score, and first-trimester arterial blood pressure showed a predictive area under the curve of 0.78 (odds ratio 3.36, = 0.008) for sPTB risk. Periodontal parameters, including PD sites >3 mm and PISA, were significantly worse in those with sPTB pregnancies ( = 0.032 and = 0.047, respectively). Both PlGF and sFlt-1 levels were elevated in pregnant women with moderate to severe periodontitis compared to those with gingivitis or a healthy status ( < 0.0001), with significant positive correlations with inflammatory periodontal clinical parameters ( < 0.05).
An early pregnancy imbalance of angiogenic and antiangiogenic factors in the GCF is associated with increased sPTB risk and greater periodontal inflammation. These findings suggest that angiogenic factors in the GCF may serve as promising non-invasive biomarkers for identifying women at elevated risk for sPTB.
新出现的证据表明，异常血管生成和血管生成因子失衡可能导致自发性早产（sPTB）的发生。此外，妊娠相关的血管生成变化和牙周组织中血管通透性增加，在激素影响下可能会加剧牙周炎症。
本研究旨在评估龈沟液（GCF）中胎盘生长因子（PlGF）和可溶性fms样酪氨酸激酶-1（sFlt-1）水平与sPTB风险之间的关联，并评估它们与孕早期牙周疾病严重程度的相关性。
进行了一项前瞻性队列研究，纳入348名孕妇，在妊娠11-14周时进行产科、临床和牙周参数评估，包括探诊深度（PD）、临床附着丧失（CAL）、探诊出血（BOP）、牙周炎症表面积（PISA）和菌斑指数评分（PI）。收集GCF样本，使用Magpix-Luminex®多重技术测量PlGF和sFlt-1水平。
3.45%（n = 12）的参与者发生了sPTB。与足月妊娠的女性相比，发生sPTB的女性GCF中PlGF/sFlt-1比值显著更高（P = 0.017），sFlt-1水平更低（P = 0.003）。结合PlGF/sFlt-1比值、PI评分和孕早期动脉血压的多变量回归模型显示，sPTB风险的曲线下预测面积为0.78（比值比3.36，P = 0.008）。在sPTB妊娠的女性中，包括PD位点>3 mm和PISA在内的牙周参数明显更差（分别为P = 0.032和P = 0.047）。与患有牙龈炎或健康状态的孕妇相比，中度至重度牙周炎孕妇的PlGF和sFlt-1水平均升高（P < 0.0001），与牙周炎症临床参数呈显著正相关（P < 0.05）。
GCF中血管生成和抗血管生成因子在孕早期的失衡与sPTB风险增加和更严重的牙周炎症相关。这些发现表明，GCF中的血管生成因子可能是识别sPTB风险升高女性的有前景的非侵入性生物标志物。
