Association between Pre-Pregnancy BMI and Inflammatory Profile Trajectories during Pregnancy and Postpartum in Brazilian Women with Periodontitis: The IMPROVE Trial

Abstract

This study aimed to explore the association between pre-pregnancy BMI and longitudinal changes in inflammatory markers from the second trimester of pregnancy to 6–8 weeks postpartum in women with periodontitis. This is a secondary exploratory analysis of 68 women who took part in a feasibility clinical trial in Rio de Janeiro, Brazil. Inflammatory markers included C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), and matrix metalloproteinase-9 (MMP-9) blood concentrations at 11–22 (T0) and 30–36 gestational weeks (T1), and 6–8 weeks postpartum (T3). Longitudinal generalised linear mixed-effects models were used to identify possible associations between pre-pregnancy BMI and changes in concentrations of inflammatory markers. Pre-pregnancy excess weight (β = 4.39; 95% CI, 2.12–6.65) was significantly associated with increased CRP levels from pregnancy to postpartum. There were no significant associations between pre-pregnancy BMI and longitudinal changes in IL-6, IL-10 and MMP-9. Our findings provide evidence that a higher pre-pregnancy BMI may lead to increases in CRP levels during pregnancy in women with periodontitis, irrespective of the severity of clinical periodontal parameters. Further studies need to investigate if predictors of changes in inflammatory markers can be used as prognostic factors for gestational outcomes.

MMP-8 in Periodontal Sites of Postpartum and without-Any-Pregnancy Women

“…In a longitudinal study [Santana and colleagues], the pre-pregnancy Body Mass Index (BMI) was significantly associated with increased C-reactive proteins levels from pregnancy to the beginning of the postpartum period among Brazilian pregnant women with periodontitis; therefore, it is necessary to investigate whether predictors of changes in inflammatory markers can be used as prognostic factors for gestational outcomes, thus collaborating with the findings of this research in which the postpartum state would increase inflammatory biomarkers [ 31 ].…”

The Impact of Periodontal Disease on Preterm Birth and Preeclampsia

“…While associations between periodontitis and preeclampsia have been established, the impacts on systemic inflammation and plasma cytokine levels remain inconsistent across studies. Although elevated CRP levels in periodontitis have shown greater consistency and significance, data regarding the relationship between pregnancy complications and inflammatory mediator levels in gingival fluid and plasma are limited [39,[43][44][45][46][47][48][49]. Despite this, elevated levels of pro-inflammatory cytokines in plasma and circulating microbes stimulate the liver to produce fibrinogen and CRP, further exacerbating systemic inflammation [39].…”