title: Increased inflammatory biomarkers in early pregnancy is associated with the development of pre-eclampsia in patients with periodontitis: a case control study.
abstract: OBJECTIVE
  To explore the relationship between biomarkers of systemic inflammation in plasma and gingival crevicular fluid in early pregnancy and the subsequent development of pre-eclampsia in patients with periodontitis.
  
  
  METHODS
  A case-control study was performed. From a cohort composed of 126 pregnant women, 43 normotensive healthy pregnant women were randomly selected, and 11 cases of preeclampsia were identified. Plasmatic and gingival crevicular fluid (GCF) samples were collected in early pregnancy (11-14 wk gestation). The levels of interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) were measured in the plasma and GCF samples, whereas the level of C-reactive protein (CRP) was measured in plasma samples. Biomarkers were determined by ELISA assays. The data were analysed using descriptive statistics, and the association between variables was estimated through logistic regression models.
  
  
  RESULTS
  There was observed an association between pre-eclampsia and plasmatic levels of CRP (OR: 1.07; p = 0.003). Additionally, pre-eclampsia also was associated with IL-6 levels in GCF samples in early pregnancy (OR: 1.05; p = 0.039). A multiple logistic regression model suggests that increased levels of IL-6 in GCF (OR = 1.06; p = 0.02; CI 95% 1.007-1.117) in early pregnancy increase the risk of developing pre-eclampsia.
  
  
  CONCLUSIONS
  Pregnant women with periodontitis who later development pre-eclampsia, shows increased levels of IL-6 in GCF and CRP in plasma during early pregnancy. Periodontal disease could contribute to systemic inflammation in early pregnancy via a local increase of IL-6 and the systemic elevation of CRP. Therefore, both inflammatory markers could be involved in the relationship between periodontal disease and pre-eclampsia.
authors.affiliation: Department of Periodontology, Dentistry Faculty, Universidad de Andes, Santiago, Chile.
authors.forename: A
authors.initials: A
authors.lastname: Chaparro
authors.forename: A
authors.initials: A
authors.lastname: Sanz
authors.forename: A
authors.initials: A
authors.lastname: Quintero
authors.forename: C
authors.initials: C
authors.lastname: Inostroza
authors.forename: V
authors.initials: V
authors.lastname: Ramirez
authors.forename: F
authors.initials: F
authors.lastname: Carrion
authors.forename: F
authors.initials: F
authors.lastname: Figueroa
authors.forename: R
authors.initials: R
authors.lastname: Serra
authors.forename: S E
authors.initials: SE
authors.lastname: Illanes
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry*; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis / Q000097:blood / Q000378:metabolism*; D016015:Logistic Models; D010518:Periodontitis / Q000097:blood / Q000150:complications* / Q000378:metabolism; D011225:Pre-Eclampsia / Q000097:blood / Q000209:etiology* / Q000378:metabolism; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood / Q000378:metabolism*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000097:blood / Q000378:metabolism; D055815:Young Adult
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein