title: Preterm birth and/or low birth weight are associated with periodontal disease and the increased placental immunohistochemical expression of inflammatory markers.
abstract: The objective of this study was to determine whether gynecological and periodontal clinical parameters and the immunohistochemical expression in placental chorionic villi of the markers cyclooxygenase-2 (COX-2), interleukin (IL)-1β, vascular endothelial growth factor receptor 1 (VEGFR1), podoplanin, and Heat Shock Protein 70 (HSP70) are associated with preterm birth (PB) and/or low birth weight (LBW) neonates.
  
  
  METHODS
  An observational case-control study was performed in 130 puerperal women: mothers of PB/LBW neonates (cases, n=65) and mothers of full-term normal-weight neonates (controls, n=65). Data were gathered from all participants on socio-demographic, gynecological, and periodontal variables and on placental immunohistochemical COX-2, IL-1β, VEGFR1, podoplanin, and HSP70 expression.
  
  
  RESULTS
  Among the 42 women with mild/moderate periodontitis or gingivitis, the studied periodontal variables were significantly worse and the placental COX-2 (p=0.043), HSP70 (p=0.001), IL-1β (p=0.001), VEGFR1 (p=0.032), and podoplanin (p=0.058) expressions were significantly higher in the cases than in the controls. In comparison to the mothers without periodontitis, only COX-2 (p=0.026) and VEGFR1 (p=0.005) expressions were significantly increased in those with the disease. Increased COX-2 values were detected in the women with a history of genitourinary infection (p=0.036), premature rupture of membrane (p=0.012), or drug treatment (p=0.050).
  
  
  CONCLUSIONS
  The etiology of preterm birth and/or low birth weight is multifactorial and involves consumption habits, social-health factors, and infectious episodes. These adverse pregnancy outcomes were associated with periodontitis and the increased placental expression of IL-1β, COX-2, VEGFR1, and HSP70.
authors.affiliation: Private practice in periodontics, Granada, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Pozo
authors.affiliation: Periodontology Department, School of Dentistry, University of Granada, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Mesa
authors.affiliation: Private practice in periodontics, Granada, Spain.
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Ikram
authors.affiliation: Department of Obstetrics and Gynecology, Virgen de las Nieves University Hospital, Granada, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Puertas
authors.affiliation: Oral Surgery Department, School of Dentistry, University of Granada, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Torrecillas-Martínez
authors.affiliation: Oral Surgery Department, School of Dentistry, University of Granada, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Ortega-Oller
authors.affiliation: Periodontology Department, School of Dentistry, University of Granada, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Magán-Fernández
authors.affiliation: Pathology Department, School of Medicine, University of Granada, Granada, Spain.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Rodríguez-Martínez
authors.affiliation: Oral Surgery Department, School of Dentistry, University of Granada, Spain and Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Miguel
authors.initials: M
authors.lastname: Padial-Molina
authors.affiliation: Oral Surgery Department, School of Dentistry, University of Granada, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Sánchez-Fernández
authors.affiliation: Oral Surgery Department, School of Dentistry, University of Granada, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Galindo-Moreno
authors.affiliation: Pathology Department, School of Medicine, University of Granada, Granada, Spain. fovalle@ugr.es.
authors.forename: Francisco
authors.initials: F
authors.lastname: O'Valle
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D002908:Chronic Disease; D051546:Cyclooxygenase 2 / Q000378:metabolism; D005260:Female; D020869:Gene Expression Profiling; D005786:Gene Expression Regulation; D018840:HSP70 Heat-Shock Proteins / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007249:Inflammation; D053583:Interleukin-1beta / Q000378:metabolism; D008562:Membrane Glycoproteins / Q000378:metabolism; D010510:Periodontal Diseases / Q000150:complications* / Q000503:physiopathology; D010518:Periodontitis / Q000378:metabolism; D010920:Placenta / Q000378:metabolism*; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D047928:Premature Birth; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000378:metabolism; D000098853:Podoplanin
chemical_list: D015415:Biomarkers; D051546:Cyclooxygenase 2; D018840:HSP70 Heat-Shock Proteins; D053583:Interleukin-1beta; D008562:Membrane Glycoproteins; D040281:Vascular Endothelial Growth Factor Receptor-1; C508585:IL1B protein, human; C117468:PDPN protein, human; D000098853:Podoplanin; C496540:PTGS2 protein, human