Presence of periodontal pathogen in preeclamptic women´s placenta: Literature review

Authors

DOI:

https://doi.org/10.33448/rsd-v9i9.7707

Keywords:

Periodontal diseases; Pregnancy complications; Microbiology.

Abstract

Objective: To explore existing studies on the association between periodontal disease during pregnancy and pre-eclampsia, in view of the recent studies that periodontal pathogens can spread through fetal and placental tissues causing adverse effects on the health of the mother child. Method: Literature review carried out through scientific documents accessed in the MEDLINE, SCIELO and LILACS-BIREME databases, using the following descriptors: periodontal disease, microbiology, pre-eclampsia and pregnancy complications. The selection of studies was carried out through the collection and analysis of the most important references on the proposed theme. Literature review: The data collected show that the production and release of inflammatory mediators resulting from lesions in the periodontium also play an important role in the pathogenesis of preeclampsia, corroborating this association. Discussion: In addition, periodontal bacteria such as Porphyromonas gingivalis, Prevotella intermedia, Agregatibacter actinomycetemcomitans and Fusobacterium nucleatum ssp have been described as participants in the process of developing preeclampsia in pregnant women with periodontal disease. Conclusion: Knowledge about the adverse effects of pre-eclampsia in patients with periodontal disease may suggest contributions to an effective prenatal control with greater attention to dental care.

References

Albert D. A., Begg, M. D., Andrews, H. F., Williams, S. Z., Ward, A., Conicella, M. L., Rauh, V., Thomson, J. L. & Papapanou, P. N. (2011). An examination of periodontal treatment, dental care, and pregnancy outcomes in an insured population in the United States. American Journal of Public Health, 101(1): 151-156. DOI: 10.2105/AJPH.2009.185884

Anderson, U. D., Olsson, M. G., Rutardóttir, S., Centlow, M., Kristensen, K. H., Isberg, P. E., Thilaganathan B., Akerströn, B. & Hansson, S. R. (2011). Fetal hemoglobin and alpha1- microglobulin as first and early second trimester predictive biomarkers for preeclampsia. American Journal of Obstetrics & Gynecology, 204(6): 520.e1–520.e5. DOI: 10.18203/2320-1770.ijrcog20183322

Arce, R. M., Barros, S. P., Wacker, B., Peters, B., Moss K. & Offenbacher, S. (2009). Increased TLR4 expression in murine placentas after oral infection with periodontal pathogens. Placenta. 30(2):156-162. DOI: 10.1016/j.placenta.2008.11.017

Armitage, G. C. (2013). Learned and unlearned concepts in periodontal diagnostics: a 50-year perspective. Periodontology 2000, 62(1):20-36. DOI: 10.1111/prd.12006

Atieh, M. A. (2008). Accuracy of real-time polymerase chain reaction versus anaerobic culture in detection of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis: a meta-analysis. Journal of Periodontology, 79:1620-1629. DOI: 10.1902/jop.2008.070668

Backes, C. H., Markham, K., Moorehead, P., Cordero, L., Nankervis, C. A & Giannone, P. J. (2011). Maternal preeclampsia and neonatal outcomes. Journal of Pregnancy, 2011:214365. DOI: 10.1155/2011/214365

Boggess, K. A., Lieff, S., Murtha, A. P., Moss, K. , Beck, J. & Offenbacher, S. (2003). Maternal periodontal disease is associated with an increased risk for preeclampsia. Obstetrics & Gynecology, 101:227-231. DOI: 10.1016/s0029-7844(02)02314-1.

Canakci, V., Canakci, C. F., Canakci, H., Canakci, E., Cicek, Y., Ingec, M., Ozgoz, M., Demir, T., Dilsiz, A. & Yagiz, H. (2004). Periodontal disease as a risk factor for pre-eclampsia: a case control study. Australian and New Zealand Journal of Obstetrics and Gynaecology, 44(6):568-73. DOI: 10.1111/j.1479-828X.2004.00323.x

Cetin, I., Pileri, P., Villa, A., Calabrese, S., Ottolenghi L. & Abati, S. (2012). Pathogenic Mechanisms Linking Periodontal Diseases With Adverse Pregnancy Outcomes. Reproductive Sciences, 19(6) 633-641. DOI: 10.1177/1933719111432871

Champple, I. L. C. & Genco, R. (2013). Diabetes and periodontal diseases: consensus report of the Joint EFP/ AAP Workshop on Periodontitis and Systemic Diseases. Journal of Periodontology, 84 (4 Suppl.): S106-S112. DOI: 10.1902/jop.2013.1340011

Chaparro, A., Sanz, A., Quintero, A., Inostroza, C., Ramirez, V., Carrion, F., Figueroa, F., Serra, R. & Illanes, S. E. (2013). Increased inflammatory biomarkers in early pregnancy is associated with the development of pre-eclampsia in patients with periodontitis: a case control study. Journal of Periodontal Research, 48:302–307. DOI: 10.1111/jre.12008

Chatkin, M. N. & Menezes, A. M. (2005). The association between low birthweight and asthma: a systematic literature review. Revista Panamericana de Salud Publica, 17(2):102-9.

Chavarria, M. E., Lara-González, L., García-Paleta, Y., Vital-Reyes, V. S. & Reyes, A. (2008). Adhesion molecules changes at 20 gestation weeks in pregnancies complicated by preeclampsia. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 137:157–164. DOI: 10.1016/j.ejogrb.2007.06.014

Contreras, A., Herrera, J. A., Soto, J. E., Arce, R. M., Jaramillo, A. & Botero, J. E. (2006). Periodontitis is associated with preeclampsia in pregnant women. Journal of Periodontology, 77:182-188. DOI: 10.1902/jop.2006.050020

Cota, L. O., Guimarães, A. N., Costa, J .E., Lorentz, T. C. M. & Costa, F. O. (2006). Association between maternal periodontitis and an increased risk of preeclampsia. Journal of Periodontology, 77(12):2063-9. DOI: 10.1902/jop.2006.060061

Cui, Y., Wang, W., Dong, N., Lou, J., Srinivasan, D.K., Cheng, W., Huang, X., Liu, M., Fang, C., Peng, J., Chen, S., Wu, S., Liu, Z., Dong L., Zhou, Y. & Wu, Q. (2012). Role of corin in trophoblast invasion and uterine spiral artery remodeling in pregnancy. Nature, 484:246–250. DOI: 10.1038/nature10897

Doucède G., Dehaynin-Toulet, E., Kacet, L., Jollant, B., Tholliez, S., Deruelle, P., & Subtil1, S. (2019). Dents et grossesse, un enjeu de santé publique. La Presse Médicale. DOI: 10.1016/j.lpm.2019.09.020

Eke, P. I., Wei, L., Thornton-Evans, G. O., Borrell, L.N., Borgnakke, W. S., Dye, B. & Genco, R. J. (2016). Risk Indicators for Periodontitis in US Adults: NHANES 2009 to 2012. Journal of Periodontology, 87: 1174-1185. DOI: 10.1902/jop.2016.160013

Fogacci, M. F., Vettore, M. V. & Thome-Leao, A. T. (2011). The effect of periodontal therapy on preterm low birth weight: a meta-analysis. Obstetrics & Gynecology, 117(1): 153-165. DOI: 10.1097/AOG.0b013e3181fdebc0

Gesase, N., Miranda-Rius, J., Brunet-Llobet, L., Lahor-Soler, E., Mahande, M. J. & Masenga, G. (2018) . The association between periodontal disease and adverse pregnancy outcomes in Northern Tanzania: a cross-sectional study. African Health Sciences, 18(3):601. DOI: 10.4314/ahs.v18i3.18

Herbert, B. A., Novince, C. M. & Kirkwood, K. L. (2016). Aggregatibacter actinomycetemcomitans, a potent immunoregulator of the periodontal host defense system and alveolar bone homeostasis. Molecular Oral Microbiology, 31(3):207-27. DOI: 10.1111/omi.12119

Horton, A. L., Boggess, K. A., Moss, K. L., Beck, J., & Offenbacher, S. (2010). Periodontal Disease, Oxidative Stress, and Risk for Preeclampsia. Journal of Periodontology, 81:199-204. DOI: 10.1902/jop.2009.090437

Irgens, H. U., Reisaeter, L., Irgens, L. M. & Lie, R. T. (2001). Long term mortality of mothers and fathers after pre-eclampsia: population based cohort study. BMJ. 323(7323):1213-7. DOI: 10.1136/bmj.323.7323.1213

Jaramillo, A., Arce, R., Contreras, A. & Herrera, J. A. (2012). Efecto del tratamiento periodontal sobre la microbiota subgingival en pacientes con preeclampsia. Biomédica, 32:233-8. DOI: 10.7705/biomedica.v32i2.661

Jung-Eun, H. A., Kyung-Joon, O h., Hye-Jin,Y., Jong-Kwan J., Bo-Hyoung J., Dai-Il, P. & Kwang-Hak, B. (2011). Oral Health Behaviors, Periodontal Disease, and Pathogens in Preeclampsia: A Case-Control Study in Korea. Journal of Periodontology, 82:1685-1692. DOI: 10.1902/jop.2011.110035

Kaur G, Holtfreter, B., Rathmann, W., Schwahn, C., Wallaschofski, H., Schipf, S., Nauck, M. & Kocher, T. (2009). Association between type 1 and type 2 diabetes with periodontal disease and tooth loss. Journal of Clinical Periodontology, 36: 765–774. DOI: 10.1111/j.1600-051X.2009.01445.x

Komine-Aizawa, S., Aizawa, S., & Hayakawa, S. (2018). Periodontal diseases and adverse pregnancy outcomes. Journal of Obstetrics and Gynaecology Research. DOI: 10.1111/jog.13782

Kumar A., Begum, N., Prasad, S., Lamba, A. K., Verma, M., Agarwal, S. & Sharma, S. (2014). Role of cytokines in development of pre-eclampsia associated with periodontal disease - Cohort Study. Journal of Clinical Periodontology, 41: 357–365. DOI: 10.1111/jcpe.12226

Kunnen A, Blaauw, J., Doormaal, J. J. V., Pampus, M. G. V., Schans, C. P. V. D., Aarnoudse, J.G., Winkelhoff, A.J.V. & Abbas, F. (2007). Women with a recent history of early-onset pre-eclampsia have a worse periodontal condition. Journal of Clinal Periodontology, 34:202-207. DOI: 10.1111/j.1600-051X.2006.01036.x

Kunnen, A., Doormaal, J. J. V., Abbas, F., Aarnoudse, J. G., Pampus, M. G. V. & Faas, M. M. (2010). Periodontal disease and pre-eclampsia: a systematic review. Journal of Clinical Periodontology, 37: 1075–1087. DOI: 10.1111/j.1600-051X.2010.01636.x

Linden, G. J & Herzberg, M. C. (2013). Periodontitis and systemic diseases: a record of discussions of working group 4 of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. Journal of Clinical Periodontology, 40 (Suppl. 14): S20–S23. DOI: 10.1111/jcpe.12091

Lo, J. O., Mission, J.F . & Caughey, A. B. (2013). Hypertensive disease of pregnancy and maternal mortality. Current Opinion in Obstetrics and Gynecology, 25, 124–132. DOI: 10.1097/GCO.0b013e32835e0ef5

Macones, G. A., Parry, S., Nelson, D. B., Strauss, J. F., Ludmirr, J., Cohen, A. W., Stamilio, D.M., Appleby, D., Clothier, B., Sammel, M.D. & Jeffcoat, M. (2010). Treatment of localized periodontal disease in pregnancy does not reduce the occurrence of preterm birth: results from the Periodontal Infections and Prematurity Study (PIPS). American Journal of Obstetrics & Gynecology, 202(2): 147. e141-e148. DOI: 10.1016/j.ajog.2009.10.892

Madianos, P. N., Bobetsis, Y. A. & Offenbacher, S. (2013). Adverse pregnancy outcomes (APOs) and periodontal disease: pathogenic mechanisms. Journal of Periodontology, 84 (4 Suppl): S170–180. DOI: 10.1111/jcpe.12082

Mahendra, J., Parthiban, P. S., Mahendra, P., Balakrishnan, A., Shanmugam, S., Junaid, M. & Romanos, G. E. (2016). Evidence Linking the Role of Placental Expressions of PPAR-γ and NF-κB in the Pathogenesis of Preeclampsia Associated With Periodontitis. Journal of Periodontology, 87(8):962-70. DOI: 10.1902/jop.2016.150677

Michaud, D. S., Fu, Z., Shi, J. & Chung, M. (2017).

Periodontal disease, tooth loss and cancer risk. Oxford Journals Epidemiologic Reviews, 39(1):4958. DOI: 10.1093/epirev/mxx006

Mineoka T., Awano, S., Rikimaru, T., Kurata, H., Yoshida, A., Ansai, T. & Takehara, T. (2008). Site-specific development of periodontal disease is associated with increased levels of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia in subgingival plaque. Journal of Periodontology, 79: 670-676. DOI: 10.1902/jop.2008.070398

Morikawa, M., Chiba, T., Tomii, N., Sato, S., Takahashi, Y., Konishi, K., Numabe, Y., Iwata, K. & Imai, K. (2008). Comparative analysis of putatite periodontopathic bacteria by multiplex polymerase chain reaction. Journal of Periodontal Research, 43: 268-274.

Mostajeran, F. & Bahareh, A. (2013). Is There Any Difference Between Preeclamptic and Healthy Pregnant Women Regarding the Presence of Periopathogenic Bacteria in the Placenta? International Journal of Preventive Medicine, 4(3): 322–326.

Nazir, M.A. (2017) Prevalence of periodontal disease, its association with systemic diseases and prevention. International Journal of Health Sciences. 11(2): 72-80.

Noris, M., Perico, N. & Remuzzi, G. (2005). Mechanisms of Disease: pre-eclampsia. Nature Clinical Practice Nephrology, 1:2. DOI: 10.1038/ncpneph0035

Oettinger-Barak, O., Barak, S., Ohel, G., Oettinger, M., Kreutzer, H., Peled, M. & Machtei, E. E. (2005). Severe pregnancy complication (preeclampsia) is associated with greater periodontal destruction. Journal of Periodontology, 76(1):134-7. DOI: 10.1902/jop.2005.76.1.134

Offenbacher, S., Beck, J. D., Jared, H. L., Mauriello, S. M., Mendoza, L. C., Couper, D .J., Stewart, D. D., Murtha, A. P., Cochran, D. L., Dudley, D. J., Reddy, M. S., Geurs, N. C., Hauth, J.C. & the Maternal Oral Therapy to Reduce Obstetric Risk (MOTOR) Investigadores. (2009). Effects of periodontal therapy on rate of preterm delivery: a randomized controlled trial. Obstetrics & Gynecology, 114(3): 551-559. DOI: 10.1097/AOG.0b013e3181b1341f.

Papapanou, P. N., Sanz, M., Buduneli, N., Dietrich, T., Feres, M., Bem, D. H., Flemming,T. F., Garcia, R., Giannobile, W. V., Graziani, F., Greenwell, H., Herrera, D., Kao, R. T., Kebschull, M., Kinane, D. F., Kirkwood, K. L., Kocher, T., Kornman, K. S., Kumar, P .S., Loos, B. G., Machtei, E., Meng, H., Mombelli, A., Needleman, I., Offenbacher, S., Seymour, G.J., Teles, R. & Tonetti, M. S. (2018). Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of Periodontology, 89:S173–82.

Parthiban, P. S., Mahendra, J., Logaranjani, A., Shanmugan, S., Balakrishnan, A., Junaid, M. & Namasivayam, A. (2018). Association between specific periodontal pathogens, Toll-like receptor-4 and nuclear factor κB expression in placental tissues of pre-eclamptic women with periodontits. Journal of Investigative and Clinical Dentistry, 9(1). DOI: 10.1111/jicd.12265

Perunovic, N. D., Rakic, M. M., Nikolic, L .I., Jankovic, S. M., et al. (2016) A associação entre a inflamação periodontal e os gatilhos do parto (níveis elevados de citocinas) no nascimento prematuro: um estudo transversal. Journal of Periodontology, 87: 248-256.

Rana, S., Lemoine, E., Granger, J., & Karumanchi, S. A. (2019). Preeclampsia. Circulation Research, 124(7): 1094–1112. DOI: 10.1161/CIRCRESAHA.118.313276

Report of the National High Blood Pressure Education Program Working Group on high blood pressure in pregnancy. American Journal of Obstetrics & Gynecology, 2000; 183:S1–S22.

Riché, E. L., Boggess, K. A., Lieff, S., Murtha, A.P., Auten, R. L., Beck, J. D. & Offenbacher, S. (2002). Periodontal disease increases the risk of preterm delivery among preeclamptic women. Annals of Periodontology, 7(1): 95-101.

Rodrigues Neto, S. C., Oliveira, E. N., Martins, B. A., Silva, I. L., Souza Júnior, A .M., Jerônimo, R. L., Sousa, J. N .L. & Alves, M. A. S.G . (2020). Avaliação da influência da doença periodontal sobre os níveis séricos de proteína C reativa. Research, Society and Development, 9(8). DOI: 10.33448/rsd-v9i8.5310

Ruby, J., Martin, M., Passineau, M. J., Godovikova, V., Fenno, J. C. & Wu, H. (2017). Activation of the Innate Immune System by Treponema denticola Periplasmic Flagella through Toll-Like Receptor 2. Infection and Immunity, 19; 86(1). DOI: 10.1128/IAI.00573-17

Sankaralingam, S., Arenas, I. A., Lalu, M. M. & Davidge, S. T. (2006). Preeclampsia: current understanding of the molecular basis of vascular dysfunction. Cambridge University Press, 8(3). DOI: 10.1017/S1462399406010465

Sanz, M. & Kornman, K. (2013). Periodontitis and adverse pregnancy outcomes: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. Journal of Periodontology, 84. (4 Suppl.). DOI: 10.1902/jop.2013.1340016

Schwendicke, F., Karimbux, N., Allareddy, V. & Gluud, C. (2015). Periodontal Treatment for Preventing Adverse Pregnancy Outcomes: A Meta- and Trial Sequential Analysis. PLoS ONE, 10(6). DOI: 10.1371/journal.pone.0129060

Sgolastra, F., Petrucci, A., Severino, M., Gatto, R. & Monaco, A. (2013). Relationship between Periodontitis and Pre-Eclampsia: A Meta-Analysis. PLoS One, 19:8(8). DOI: 10.1371/journal.pone.0071387

Sibbai, B., Dekker, G. & Kupferminc, M. Pre-eclampsia. Lancet, 2005;365:785-799. DOI: 10.1016/S0140-6736(05)17987-2

Silva, H. E. C., Stefani, C. M., Melo, N. S., Lima, A. A., Rösing, C. K., Porporatti, A. L. & Canto, G.L. (2017). Effect of intra-pregnancy nonsurgical periodontal therapy on inflammatory biomarkers and adverse pregnancy outcomes: a systematic review with meta-analysis. Systematic Reviews, 6:197. DOI: 10.1186/s13643-017-0587-3.

Siqueira, F. M., Cota, L. O. M., Cota, J. E., Haddad, J. P. A., Lana, A. M. Q. & Costa, F .O. (2008). Maternal periodontitis as a potential risk variable for preeclampsia: A case-control study. Journal of Periodontology, 79:207-215. DOI: 10.1902/2008.070174

Tanner, A. C. & Izard, J. (2006). Tannerella forsythia, a periodontal pathogen entering the genomic era. Periodontology 2000, 42:88-113. DOI: 10.1111/j.1600-0757.2006.00184.x

Teshome, A. & Yitayeh, A. (2016). Relação entre doença periodontal e baixo peso ao nascer pré-termo: revisão sistemática. The Pan Africa Medical Journal, 24:215.

Tonetti, M. S. & Van Dyke, T. E. (2013). Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. Journal of Periodontology, 84 (4 Suppl.): S24-S29. DOI: 10.1902/jop.2013.1340019

Torrungruang, K., Bandhaya, P., Likittanasombat, K. & Grittayaphong, C. (2009). Relationship between the presence of certain bacterial pathogens and periodontal status of urban Thai adults. Journal of Periodontology, 80: 122-129. DOI: 10.1902/jop.2009.080248

Tribble, G. D., Kerr, J. E. & Wang, B. Y. (2013). Genetic diversity in the oral pathogen Porphyromonas gingivalis: molecular mechanisms and biological consequences. Future Microbiology, 8(5):607-20. DOI: 10.2217/fmb.13.30

Wara-Aswapati, N., Pitiphat, W., Chanchaimongkon, L., Taweechaisupapong, S., Boch, J. A. & Ishikawa, I. (2009). Red bacterial complex is associated with the severity of chronic periodontitis in a Thai population. Oral diseases, 15:354-359. DOI: 10.1111/j.1601-0825.2009.01562.x

White, D. A., Tsakos, G., Pitts, N. B., Fuller, E., Douglas, G. V. A., Murray, J. J. & Steele, J. G. (2012). Adult Dental Health Survey 2009: common oral health conditions and their impact on the population. British Dental Journal, 213: 567-572. DOI: 10.1038/sj.bdj.2012.1088

World Health Organization (WHO). (2003). Workshop on the effectiveness of community based oral health promotion and oral disease prevention.

Xiong, X., Buekens, P., Goldenberg, R. L., Offenbacher, S. & Qian, X. (2011). Optimal timing of periodontal disease treatment for prevention of adverse pregnancy outcome: before or during pregnancy? American Journal of Obstetrics & Gynecology, 205(2):111. e1-e6. DOI: 10.1016/j.ajog.2011.03.017

Published

30/08/2020

How to Cite

SANTOS, M. P. de M. .; BARBOSA, L. M.; FONSECA, E. L. G. da .; LIMA, C. H. R. de .; SILVA, T. C. L. da; SOUZA, T. G. dos S. .; PINTO , P. S. .; NEGREIROS, J. H. C. N. .; GATIS, M. C. de Q. .; LAUREANO FILHO, J. R. Presence of periodontal pathogen in preeclamptic women´s placenta: Literature review. Research, Society and Development, [S. l.], v. 9, n. 9, p. e556997707, 2020. DOI: 10.33448/rsd-v9i9.7707. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/7707. Acesso em: 23 apr. 2024.

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Health Sciences