Ganesh P R, Mangaiyarkarasi M, Anagol Rachana
Department of Periodontics, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India.
Department of Obstetrics and Gynecology, Madras Medical College & ISOG, Chennai, Tamil Nadu, India.
J Indian Soc Periodontol. 2025 Mar-Apr;29(2):123-129. doi: 10.4103/jisp.jisp_85_24. Epub 2025 Aug 19.
Periodontal disease is suspected to play a causal role in adverse pregnancy outcomes like preeclampsia, which is a serious complication of end-stage pregnancy. This study investigated the periodontal status of immediate postpartum women with preeclampsia and compared it with women with normal uncomplicated pregnancy and childbirth.
The primary aim is to determine the risk of association between maternal periodontal disease and preeclampsia. The secondary outcome is determining whether C-reactive protein (CRP) levels are a potential mediator of this association.
A retrospective case-control study was conducted during a 1-year period among 200 postpartum women with preeclampsia complications and normal gestation on a 1:1 ratio. All the study participants were examined by a qualified periodontist within 48 h postpartum to assess periodontal status and 5 ml of blood drawn for estimation of CRP levels. This correlation was assessed using Spearman's correlation.
Statistical analysis by Pearson's Chi-square test and Spearman's rank correlation showed 46% of the study population had chronic periodontitis, out of which 7% had nonsevere preeclampsia without complications and 3% had severe life-threatening preeclampsia with complications (odds ratio 2.49, confidence interval 95% = 0.001). Furthermore, both the gestational period and mean birth weight decreased with the increasing severity of periodontitis. The increase in CRP levels was positively correlated, as shown by the one-way ANOVA with both periodontitis and preeclampsia, along with gestational period and birth weight of infants.
After adjusting for other risk factors, there is a significant association between maternal periodontitis and preeclampsia complications and a significant correlation between increased CRP levels, increasing severity of periodontitis, and mean birth weight. As periodontitis is a treatable disease. severe adverse pregnancy complication like preeclampsia can be prevented with early diagnosis and management of periodontal health.
牙周疾病被怀疑在诸如子痫前期等不良妊娠结局中起因果作用，子痫前期是晚期妊娠的一种严重并发症。本研究调查了患有子痫前期的产后即刻女性的牙周状况，并将其与正常无并发症妊娠和分娩的女性进行比较。
主要目的是确定母体牙周疾病与子痫前期之间的关联风险。次要结果是确定C反应蛋白（CRP）水平是否是这种关联的潜在介导因素。
在1年期间对200例患有子痫前期并发症的产后女性和正常妊娠女性进行1:1比例的回顾性病例对照研究。所有研究参与者在产后48小时内由合格的牙周病医生进行检查，以评估牙周状况，并抽取5毫升血液用于估计CRP水平。使用Spearman相关性评估这种相关性。
通过Pearson卡方检验和Spearman秩相关性进行的统计分析表明，46%的研究人群患有慢性牙周炎，其中7%患有无并发症的非重度子痫前期，3%患有伴有并发症的严重危及生命的子痫前期（比值比2.49，95%置信区间=0.001）。此外，随着牙周炎严重程度的增加，妊娠期和平均出生体重均下降。CRP水平的升高呈正相关，单因素方差分析显示牙周炎、子痫前期以及妊娠期和婴儿出生体重之间均如此。
在调整其他风险因素后，母体牙周炎与子痫前期并发症之间存在显著关联，CRP水平升高、牙周炎严重程度增加与平均出生体重之间存在显著相关性。由于牙周炎是一种可治疗的疾病，通过早期诊断和牙周健康管理可以预防子痫前期等严重不良妊娠并发症。
