Distribution of anaerobic bacteria among pregnant periodontitis patients who experience preterm delivery

Urbán, Edit; Radnai, Márta; Novák, Tibor; Gorzó, István; Pál, Attila; Nagy, Elisabeth

doi:10.1016/j.anaerobe.2005.08.001

Cited by 21 publications

(23 citation statements)

References 21 publications

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“…We also indentified that, in women with BV and gingivitis and in comparison with those with BV but not gingivitis, the vaginal samples demonstrated significantly higher counts of bacteria commonly associated with periodontal disease including: A. actinomycetemcomitans (Y4), Fusobacterium sp., P. micra, P. intermeda P. gingivalis , and T. forsythia . The role of these bacteria as potential infectious etiological factors in adverse pregnancy outcomes in the context of oral/gingival infection needs to be further explored as also indicated by others [8,15]. The fact that some bacterial species were found at higher counts in the vaginal samples of women with BV and gingivitis than among those only with BV may be an important observation suggesting that having gingivitis has an impact on the bacterial load in women with BV.…”

Section: Discussionmentioning

confidence: 86%

“…have been associated with BV [12], whereas Prevotella intermedia and Porphyromonas gingivalis have been associated with periodontal disease [13,14]. Higher counts of colony forming units of P. gingivalis in subgingival samples have also been observed in women who subsequently delivered prematurely [8,15]. Despite such findings, the biological relationship between oral and vaginal infections has not been extensively studied.…”

Section: Introductionmentioning

confidence: 99%

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The vaginal microflora in relation to gingivitis

et al. 2009

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BackgroundGingivitis has been linked to adverse pregnancy outcome (APO). Bacterial vaginosis (BV) has been associated with APO. We assessed if bacterial counts in BV is associated with gingivitis suggesting a systemic infectious susceptibilty.MethodsVaginal samples were collected from 180 women (mean age 29.4 years, SD ± 6.8, range: 18 to 46), and at least six months after delivery, and assessed by semi-quantitative DNA-DNA checkerboard hybridization assay (74 bacterial species). BV was defined by Gram stain (Nugent criteria). Gingivitis was defined as bleeding on probing at ≥ 20% of tooth sites.ResultsA Nugent score of 0–3 (normal vaginal microflora) was found in 83 women (46.1%), and a score of > 7 (BV) in 49 women (27.2%). Gingivitis was diagnosed in 114 women (63.3%). Women with a diagnosis of BV were more likely to have gingivitis (p = 0.01). Independent of gingival conditions, vaginal bacterial counts were higher (p < 0.001) for 38/74 species in BV+ in comparison to BV- women. Counts of four lactobacilli species were higher in BV- women (p < 0.001). Independent of BV diagnosis, women with gingivitis had higher counts of Prevotella bivia (p < 0.001), and Prevotella disiens (p < 0.001). P. bivia, P. disiens, M. curtisii and M. mulieris (all at the p < 0.01 level) were found at higher levels in the BV+/G+ group than in the BV+/G- group. The sum of bacterial load (74 species) was higher in the BV+/G+ group than in the BV+/G- group (p < 0.05). The highest odds ratio for the presence of bacteria in vaginal samples (> 1.0 × 104 cells) and a diagnosis of gingivitis was 3.9 for P. bivia (95% CI 1.5–5.7, p < 0.001) and 3.6 for P. disiens (95%CI: 1.8–7.5, p < 0.001), and a diagnosis of BV for P. bivia (odds ratio: 5.3, 95%CI: 2.6 to 10.4, p < 0.001) and P. disiens (odds ratio: 4.4, 95% CI: 2.2 to 8.8, p < 0.001).ConclusionHigher vaginal bacterial counts can be found in women with BV and gingivitis in comparison to women with BV but not gingivitis. P. bivia and P. disiens may be of specific significance in a relationship between vaginal and gingival infections.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

The vaginal microflora in relation to gingivitis

et al. 2009

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“…The possible explanation for this might be that different populations may be subject to different risk factors for the development of a specific pathology. Furthermore, some important periodontal pathogens have significantly been associated with PTLBW [11,12,56]. Since this was beyond the scope of the present study, it remains a subject for further research in Tanzania, preferably using most modern techniques such as checkerboard DNA-DNA hybridization and polymerase chain-reaction (PCR) techniques [10,11,19,49].…”

Section: Discussionmentioning

confidence: 99%

Maternal oral health status and preterm low birth weight at Muhimbili National Hospital, Tanzania: a case-control study

Mumghamba

Manji

2007

BMC Oral Health

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BackgroundThe study examined the relationship between oral health status (periodontal disease and carious pulpal exposure (CPE)) and preterm low-birth-weight (PTLBW) infant deliveries among Tanzanian-African mothers at Muhimbili National Hospital (MNH), Tanzania.MethodsA retrospective case-control study was conducted, involving 373 postpartum mothers aged 14–44 years (PTLBW – 150 cases) and at term normal-birth-weight (TNBW) – 223 controls), using structured questionnaire and full-mouth examination for periodontal and dentition status.ResultsThe mean number of sites with gingival bleeding was higher in PTLBW than in TNBW (P = 0.026). No significant differences were observed for sites with plaque, calculus, teeth with decay, missing, filling (DMFT) between PTLBW and TNBW. Controlling for known risk factors in all post-partum (n = 373), and primiparaous (n = 206) mothers, no significant differences were found regarding periodontal disease diagnosis threshold (PDT) (four sites or more that had probing periodontal pocket depth 4+mm and gingival bleeding ≥ 30% sites), and CPE between cases and controls. Significant risk factors for PTLBW among primi- and multiparous mothers together were age ≤ 19 years (adjusted Odds Ratio (aOR) = 2.09, 95% Confidence interval (95% CI): 1.18 – 3.67, P = 0.011), hypertension (aOR = 2.44, (95% CI): 1.20 – 4.93, P = 0.013) and being un-married (aOR = 1.59, (95% CI): 1.00 – 2.53, P = 0.049). For primiparous mothers significant risk factors for PTLBW were age ≤ 19 years (aOR = 2.07, 95% CI: 1.13 – 3.81, P = 0.019), and being un-married (aOR = 2.58, 95% CI: 1.42 – 4.67, P = 0.002).ConclusionsThese clinical findings show no evidence for periodontal disease or carious pulpal exposure being significant risk factors in PTLBW infant delivery among Tanzanian-Africans mothers at MNH, except for young age, hypertension, and being unmarried. Further research incorporating periodontal pathogens is recommended.

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“…Specific microbes are both positively or negatively associated with increased risk of PTB: in a case control study of 53 Turkish women with preterm low birth weight babies and 128 women with term babies, P. micros and C. rectus significantly increased and P. nigrescens and A. actinomycetemcomitans significantly decreased risk of preterm delivery of low birth weight babies (114). A study among 161 Hungarian women found higher levels of periodontal pathogens, P. gingivalis, P. nigrescens, T.forsythensis, A. actinomycetemcomitans, F. nucleatum, T.denticola, M. micros, C. rectus, E. corrodens, E. nodatum , and S. intermedius in the PTB cases than controls (115). However, a recent study in the USA did not show significant differences between periodontal pathogens in preterm and term births (116).…”

Section: Oral Flora and Ptbmentioning

confidence: 99%

Vaginal and oral microbes, host genotype and preterm birth

et al. 2009

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Preterm birth (PTB) is a leading cause of infant mortality and morbidity in the U.S. and across the globe. Infection and associated inflammation are important initiators for PTB pathways; an estimated 40% of PTBs are attributed to amniochorionic-decidual or systemic inflammation. Historically, intrauterine infections have been implicated in PTB; recent evidence suggests that infections remote from the fetal site may also be causative. There is strong epidemiological evidence that bacterial vaginosis and periodontitis -- two syndromes characterized by perturbations in the normal vaginal and oral bacterial microflora respectively-- are linked to infection-associated PTB. Oral and vaginal environments are similar in their bacterial microbiology; identical bacterial species have been independently isolated in periodontitis and bacterial vaginosis. Periodontitis and bacterial vaginosis also share many behavioral and sociodemographic risk factors suggesting a possible common pathophysiology. Genetic polymorphisms in host inflammatory responses to infection are shared between bacterial vaginosis, periodontitis and PTB, suggesting common mechanisms through which host genotype modify the effect of abnormal bacterial colonization on preterm birth. We review the state of knowledge regarding the risk of PTB attributable to perturbations in bacterial flora in oral and vaginal sites and the role of host genetics in modifying the risk of infection-related PTB. We posit that bacterial species that are common in perturbed vaginal and oral sites are associated with PTB through their interaction with the host immune system.

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Distribution of anaerobic bacteria among pregnant periodontitis patients who experience preterm delivery

Cited by 21 publications

References 21 publications

The vaginal microflora in relation to gingivitis

The vaginal microflora in relation to gingivitis

Maternal oral health status and preterm low birth weight at Muhimbili National Hospital, Tanzania: a case-control study

Vaginal and oral microbes, host genotype and preterm birth

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