title: The Association Between Periodontal Inflammation and Labor Triggers (Elevated Cytokine Levels) in Preterm Birth: A Cross-Sectional Study.
abstract: BACKGROUND
  Periodontitis is considered to be a risk factor for preterm birth. Mechanisms have been proposed for this pathologic relation, but the exact pathologic pattern remains unclear. Therefore, the objective of the present study is to evaluate levels of four major labor triggers, prostaglandin E2 (PGE2), interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α, in gingival crevicular fluid (GCF) and serum samples between women with preterm birth (PTB) and full-term birth (FTB) and correlate them with periodontal parameters.
  
  
  METHODS
  PGE2, IL-1β, IL-6, and TNF-α levels were estimated using enzyme-linked immunosorbent assays in GCF and serum samples collected 24 to 48 hours after labor from 120 women (60 FTB, 60 PTB).
  
  
  RESULTS
  Women with PTB exhibited significantly more periodontitis, worse periodontal parameters, and increased GCF levels of IL-6 and PGE2 compared with the FTB group; there were no significant differences in serum levels of measured markers. GCF levels of IL-1β, IL-6, and PGE2 and serum levels of TNF-α and PGE2 were significantly higher in women with periodontitis compared with periodontally healthy women. Serum levels of PGE2 were positively correlated with probing depth (PD) and clinical attachment level (CAL) as well as with GCF levels of TNF-α in women with PTB.
  
  
  CONCLUSIONS
  Women with PTB demonstrated worse periodontal parameters and significantly increased GCF levels of IL-6 and PGE2 compared with those with FTB. Based on significant correlations among serum PGE2 and PD, CAL, and GCF TNF-α in PTB, periodontitis may cause an overall increase of labor triggers and hence contribute to preterm labor onset.
authors.affiliation: Department of Periodontology and Oral Medicine, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Neda Dj
authors.initials: NDj
authors.lastname: Perunovic
authors.affiliation: Institute for Biological Research "Sinisa Stankovic," University of Belgrade.|Centre for Osteoarticular and Dental Tissue Engineering, INSERM U791, Faculty of Dental Surgery, University of Nantes, Nantes, France.
authors.forename: Mia M
authors.initials: MM
authors.lastname: Rakic
authors.affiliation: Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Ljubinka I
authors.initials: LI
authors.lastname: Nikolic
authors.affiliation: Department of Periodontology and Oral Medicine, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Sasa M
authors.initials: SM
authors.lastname: Jankovic
authors.affiliation: Department of Periodontology and Oral Medicine, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Zoran M
authors.initials: ZM
authors.lastname: Aleksic
authors.affiliation: Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Darko V
authors.initials: DV
authors.lastname: Plecas
authors.affiliation: Department of Periodontology, School of Dentistry, University of Athens, Hellas, Greece.
authors.forename: Phoebus N
authors.initials: PN
authors.lastname: Madianos
authors.affiliation: Department of Periodontology and Oral Medicine, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Sasa S
authors.initials: SS
authors.lastname: Cakic
mesh_terms: D003430:Cross-Sectional Studies; D016207:Cytokines; D005260:Female; D005883:Gingival Crevicular Fluid; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation; D010512:Periodontal Index; D010518:Periodontitis; D011247:Pregnancy; D047928:Premature Birth
chemical_list: D016207:Cytokines
keywords: Cytokines. periodontal diseases; periodontitis; pregnancy outcome; premature birth; prostaglandin E2