title: Porphyromonas gingivalis within Placental Villous Mesenchyme and Umbilical Cord Stroma Is Associated with Adverse Pregnancy Outcome.
abstract: Intrauterine presence of Porphyromonas gingivalis (Pg), a common oral pathobiont, is implicated in preterm birth. Our aim was to determine if the location of Pg within placental and/or umbilical cord sections was associated with a specific delivery diagnosis at preterm delivery (histologic chorioamnionitis, chorioamnionitis with funisitis, preeclampsia, and preeclampsia with HELLP-syndrome, small for gestational age). The prevalence and location of Pg within archived placental and umbilical cord specimens from preterm (25 to 32 weeks gestation) and term control cohorts were evaluated by immunofluorescent histology. Detection of Pg was performed blinded to pregnancy characteristics. Multivariate analyses were performed to evaluate independent effects of gestational age, being small for gestational age, specific preterm delivery diagnosis, antenatal steroids, and delivery mode, on the odds of having Pg in the preterm tissue. Within the preterm cohort, 49 of 97 (51%) placentas and 40 of 97 (41%) umbilical cord specimens were positive for Pg. Pg within the placenta was significantly associated with shorter gestation lengths (OR 0.63 (95%CI: 0.48-0.85; p = 0.002) per week) and delivery via caesarean section (OR 4.02 (95%CI: 1.15-14.04; p = 0.03), but not with histological chorioamnionitis or preeclampsia. However, the presence of Pg in the umbilical cord was significantly associated with preeclampsia: OR 6.73 (95%CI: 1.31-36.67; p = 0.02). In the term cohort, 2 of 35 (6%) placentas and no umbilical cord term specimens were positive for Pg. The location of Pg within the placenta was different between preterm and term groups in that Pg within the villous mesenchyme was only detected in the preterm cohort, whereas Pg associated with syncytiotrophoblasts was found in both preterm and term placentas. Taken together, our results suggest that the presence of Pg within the villous stroma or umbilical cord may be an important determinant in Pg-associated adverse pregnancy outcomes.
authors.affiliation: Department of Pediatrics, Maastricht University Medical Center, Maastricht, the Netherlands.|School for Mental Health and Neurosciences (MHeNS), Maastricht University, Maastricht, the Netherlands.
authors.forename: Sizzle F
authors.initials: SF
authors.lastname: Vanterpool
authors.affiliation: Department of Pediatrics, Maastricht University Medical Center, Maastricht, the Netherlands.|School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands.|Division of Neonatology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
authors.forename: Jasper V
authors.initials: JV
authors.lastname: Been
authors.affiliation: Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Michiel L
authors.initials: ML
authors.lastname: Houben
authors.affiliation: Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Peter G J
authors.initials: PG
authors.lastname: Nikkels
authors.affiliation: Department of Pathology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Ronald R
authors.initials: RR
authors.lastname: De Krijger
authors.affiliation: Department of Pediatrics, Maastricht University Medical Center, Maastricht, the Netherlands.|School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, the Netherlands.
authors.forename: Luc J I
authors.initials: LJ
authors.lastname: Zimmermann
authors.affiliation: Department of Pediatrics, Maastricht University Medical Center, Maastricht, the Netherlands.|School for Mental Health and Neurosciences (MHeNS), Maastricht University, Maastricht, the Netherlands.|School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, the Netherlands.
authors.forename: Boris W
authors.initials: BW
authors.lastname: Kramer
authors.affiliation: Department of Oral Biology, Center for Molecular Microbiology, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Ann
authors.initials: A
authors.lastname: Progulske-Fox
authors.affiliation: Department of Oral Biology, Center for Molecular Microbiology, University of Florida, Gainesville, Florida, United States of America.|Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America.
authors.forename: Leticia
authors.initials: L
authors.lastname: Reyes
mesh_terms: D000328:Adult; D002821:Chorioamnionitis / Q000175:diagnosis / Q000382:microbiology; D005260:Female; D006801:Humans; D008648:Mesoderm / Q000382:microbiology*; D010920:Placenta / Q000382:microbiology*; D016966:Porphyromonas gingivalis / Q000302:isolation & purification*; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000382:microbiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D017154:Stromal Cells / Q000382:microbiology*; D014470:Umbilical Cord / Q000382:microbiology*