Association of periodontal disease with depression and adverse birth outcomes: Results from the Perinatal database; Finger Lakes region, New York State

Abstract

Preterm and low birth weight infants are at greater risk for mortality and a variety of health and developmental problems. Data from the Finger Lakes Perinatal Data System database on 316,956 deliveries occurring between 2004–2014 and pregnancy outcomes were analyzed to assess the association of periodontal (gum) disease with depression, other maternal factors and adverse birth outcomes. Adjusted effects of periodontal disease and depression on adverse birth outcomes were estimated using multiple logistic regression models and path analysis. Having preterm delivery was associated significantly with depression (OR = 1.177; 95% CI: [1.146, 1.208]), having adequate health care (OR = 1.638; 95% CI: [1.589, 1.689]), smoking during pregnancy (OR = 1.259; 95% CI: [1.220, 1.300]), and being less educated (OR = 1.214; 95% CI: [1.174, 1.256]). Having low birth weight was significantly associated with depression (OR = 1.206; 95% CI: [1.170, 1.208]), smoking during pregnancy (OR = 1.855; 95% CI: [1.793, 1.919]), and being less educated (OR = 1.322; 95% CI: [1.275, 1.370]). Periodontal disease was significantly associated with alcohol use during pregnancy (OR = 1.314; 95% CI: [1.227, 1.407]) and white race (OR = 1.192; 95% CI: [1.167, 1.217]). Depression was significantly associated with periodontal disease (OR = 1.762; 95% CI: [1.727, 1.797]) and alcohol use during pregnancy (OR = 1.470; 95% CI: [1.377, 1.570]). We concluded that a positive association existed between depression during pregnancy and adverse birth outcomes, and that depression served as a mediator in the association of periodontal disease with adverse birth outcomes.

Prevalence and Risk Factors for Periodontal Disease Among Women Attending Antenatal Care in Public Hospitals, Southwest Ethiopia, 2022: A Multicenter Cross-Sectional Study

“…Moreover, psycho-social factors like women with self-reported scoring of depression are associated with periodontal disease. This study is supported by the studies conducted in the Finger Lakes region, New York State, 93 and in India. 94 This biological plausibility for an association between depression and periodontal disease is due to the fact that depression affects the immune system due to the disturbance in the hypothalamic-pituitary-thyroid system.…”

Microbiological findings of the maternal periodontitis associated to low birthweight

“…Although it is well established that increases in hormone levels during pregnancy may cause significant exacerbation of gingivitis, ( 1 ) it was not until the 1990s, that evidence regarding associations between maternal periodontitis and undesirable pregnancy outcomes, such as preterm birth (PTB) and low birthweight (LBW), began to emerge. ( 2 , 3 ) Modest but statistically significant associations ( 4 ) were found in observational studies, even after controlling for factors that contribute to both periodontitis and adverse pregnancy outcomes. ( 5 ) However, intervention studies failed to show that periodontal therapy reduced the overall rates of PTB and LBW.…”

“…Embora esteja bem estabelecido que o aumento dos níveis hormonais durante a gravidez possa causar exacerbação significativa da gengivite, ( 1 ) foi somente a partir da década de 1990 que começaram a ser observadas associações entre a periodontite materna e os desfechos indesejáveis da gestação, como parto pré-termo (PTT) e baixo peso ao nascer (BPN). ( 2 , 3 ) Foram encontradas associações moderadas, porém significativas, ( 4 ) em estudos observacionais, mesmo após o controle de fatores que contribuem tanto para a periodontite quanto para os desfechos adversos da gravidez. ( 5 ) Contudo, em estudos de intervenção, não foi possível mostrar que o tratamento periodontal resultasse em redução nas taxas gerais de PTT e BPN.…”

Relação entre doença periodontal, prematuridade e baixo peso ao nascer: uma revisão integrativa da literatura

“…Os 16 artigos foram considerados para a revisão integrativa. Um estudo foi excluído [29], pois avaliava DP de forma autorreportada, representando um viés de confundimento para diagnóstico da periodontite.…”