title: Periodontal disease in pregnant patients with rheumatic valvular disease: clinical and microbiological study.
abstract: BACKGROUND
  The periodontal disease during pregnancy of women with rheumatic valve disease imply infective endocarditis risks and higher rate of preterm birth and low birth weight.
  
  
  OBJECTIVE
  To study the periodontal disease rate of women with rheumatic valve disease during pregnancy.
  
  
  METHODS
  We studied 140 pregnant women who included 70 patients with rheumatic valve disease and 70 healthy women. The periodontal examination included: 1) periodontal clinical exam regard the follow variables: a) probing depth; b) gingival margin; c) clinical attachment level; d) bleeding on probing; e) plaque index and f) gingival index; and 2) microbiological test was performed in samples serum and gingival crevicular fluid and considered positive controls to Porphyromonas gingivalis, Tannerella forsithia e Aggregobacter actinomycetemcomitans.
  
  
  RESULTS
  Age and parity were similar between groups; as single or combined the mitral valve disease was prevalent among the rheumatic valve lesion in 45 (32.1%) e 20 (28.5%) cases, respectively. Among the periodontal variables gingival margin (p=0.01) and plaque index (p=0.04) were different between groups. The periodontal disease was identified in 20 (14,3%) pregnant women, seven (10%) of them were patients with valve rheumatic disease and the remain 13 (18,6%) were healthy women, its percentual was not different between groups (p=0,147). Microbiological analyses of oral samples showed higher percentual of P. gingivalis in healthy pregnant women (p=0.004).
  
  
  CONCLUSIONS
  The clinical and microbiological study during pregnancy showed comparable incidence of periodontal disease between women with rheumatic valve disease and healthy women.
authors.affiliation: Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil. wsavila@cardiol.br
authors.forename: Walkiria Samuel
authors.initials: WS
authors.lastname: Avila
authors.forename: Lilia
authors.initials: L
authors.lastname: Timerman
authors.forename: Giuseppe Alexandre
authors.initials: GA
authors.lastname: Romito
authors.forename: Sílvia Linard
authors.initials: SL
authors.lastname: Marcelino
authors.forename: Itamara Lúcia Itagiba
authors.initials: IL
authors.lastname: Neves
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
authors.forename: Max
authors.initials: M
authors.lastname: Grinberg
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006349:Heart Valve Diseases / Q000382:microbiology*; D006801:Humans; D009055:Mouth / Q000382:microbiology; D009909:Oral Health; D010510:Periodontal Diseases / Q000150:complications* / Q000453:epidemiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000382:microbiology*; D015995:Prevalence; D012307:Risk Factors; D012463:Saliva / Q000382:microbiology; D055815:Young Adult