Serum inflammatory mediators in pregnancy: changes after periodontal treatment and association with pregnancy outcomes.
BACKGROUND
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Michalowicz
Bryan S
BS
Department of Developmental and Surgical Sciences, University of Minnesota School of Dentistry, Minneapolis, MN, USA. micha002@umn.edu
Novak
M John
MJ
Hodges
James S
JS
DiAngelis
Anthony
A
Buchanan
William
W
Papapanou
Panos N
PN
Mitchell
Dennis A
DA
Ferguson
James E
JE
Lupo
Virginia
V
Bofill
James
J
Matseoane
Stephen
S
Steffen
Michelle
M
Ebersole
Jeffrey L
JL
D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D002097:C-Reactive Protein / Q000032:analysis; D012534:Dental Scaling; D015232:Dinoprostone / Q000097:blood; D004731:Endotoxins / Q000097:blood; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D018836:Inflammation Mediators / Q000097:blood*; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D010518:Periodontitis / Q000097:blood / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000628:therapy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000097:blood; D012307:Risk Factors; D016745:Root Planing; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
D004731:Endotoxins; D018836:Inflammation Mediators; D053583:Interleukin-1beta; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D005340:Fibrinogen; D002097:C-Reactive Protein; D020780:Matrix Metalloproteinase 9; D015232:Dinoprostone