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Oral Infections and Adverse Pregnancy Outcomes

In February, 2010, the National Institute of Health published an announcement stating that premature birth affects 13 million infants world wide each year and that 1 out of 3 preterm infants is born to a mother who has a silent infection of the amniotic fluid.

Growing evidence supports the concept that gingival infection plays a role in pregnancy complications, inducing premature birth as well as inhibiting the growth and development of the unborn child.

The increase in hormonal activity during pregnancy can cause gingival tissues to bleed more easily and may promote bacterial overgrowth. Increased numbers of Prevotella intermedia have been found in the biofilm in pregnancy gingivitis. Studies at Case Western Reserve University (Y.W. Han, 2006) demonstrated that maternal oral bacteria have been found in human amniotic fluid showing that there is direct movement of oral periodontal pathogens through the blood to the fetus.

Two separate studies, one in Chile and the other in the United States have similar results. In the Chilean study (Lopez N. 2002) 400 pregnant women with periodontal disease were in the study. Of the half of these women that had scaling and root planing during pregnancy, 1.8 percent gave birth early. The other half of the study did not have any scaling or root planing until after delivery. In this group, 10.1 percent gave birth early.

In a study of 123 mothers who received periodontal treatment prior to delivery (Jeffcoat M. University of Alabama), 4.1 percent gave birth early whereas another group of 733 mothers with untreated periodontal disease had an early delivery rate of 13.7 percent.

Lopez, NJ.; Smith, PC.; and Gutierrez, J.: Higher risk of preterm birth and low birth weight in women with periodontal disease. J Dent Res. 81(1): 58-63, 2002.

Jeffcoat, MK.; Geurs, NC.; Reddy, MS.; Cliver, SP.; Goldenberg, RL.; and Hauth, JC.: Periodontal infection and preterm birth: results of a prospective study. J Am Dent Assoc. 132: 875-880, 2001.

NIHPRESS@LIST.NIH.Gov.: NIH scientists identify maternal and fetal genes that increase preterm birth risk. February 4, 2010.

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