Localization of P. gingivalis in Preterm Delivery Placenta

Abstract

Increasing evidence suggests an association between periodontal disease and adverse pregnancy outcomes. Although infection is considered as a risk factor for preterm delivery, the localization of oral bacteria or their antigens in chorioamnionitis placental tissue has never been demonstrated. This study was devised to test the hypothesis that periodontal pathogens may be present and affect human placenta in cases of chorioamnionitis. Using immunocytochemistry, we have identified the presence of Porphyromonas gingivalis antigens in placental tissues. The antigens were detected in the placental syncytiotrophoblasts, chorionic trophoblasts, decidual cells, and amniotic epithelial cells, as well as the vascular cells. There was a substantial increase in immunostaining intensity of the tissues sectioned from women with chorioamnionitis compared to those experiencing normalterm pregnancy, p < 0.019 (Mann-Whitney test). These results suggest that P. gingivalis may commonly colonize placental tissue, and that the presence of the organism may contribute to preterm delivery.

Porphyromonas gingivalisand adverse pregnancy outcome

“…As a periodontal pathogen, P. gingivalis may indirectly contribute to adverse pregnancy outcomes (APO) by facilitating the release of bacterial products or inflammatory mediators into the maternal circulation that reach the maternal-fetal interface [2]. P. gingivalis could also directly promote APO via invasion and injury to utero-placental tissues; this is supported by several studies that have detected P. gingivalis DNA/antigen in the placenta, amniotic fluid, umbilical cord, and neonatal nasogastric aspirates from complicated pregnancies [3][4][5][6][7][8][9][10][11]. However, the significance of P. gingivalis as a causative agent of APO is sometimes viewed with skepticism due to several confounding factors.…”

Association of Periodontal Disease and Pre-term Low Birth Weight Infants

“…Analysis of the amniotic fluid shows the presence of periodontal pathogens like Eikenella [17], F.nucleatum, P. gingivalis [18,19]. These pathogenic bacteria induce cytokine formation, neutrophil activation, MMP synthesis which induces pre-term labor.…”

“…The pathologic mechanism of the periopathogen shows that it could infect syncytiotrophoblasts, chorionic trophoblasts, and amniotic epithelial cells [19] and promote inflammatory process through Toll like receptor 4. A case report of a stillbirth caused by F. nucleatum from the mother's mouth highlights the fact that an oral periodontal pathogen can, by hematologic pathway, colonize placenta and provoke fetal complications [20].…”

Effect of Periodontal Infection on Birth Weight of Infants: A Clinical and Microbiological Study*

“…Katz et al (2009) observed that gram negative periodontopathogens get localised in the placenta resulting in chorioamnionitis, infected amniotic fluid or a fetal inflammatory response [16]. This has an adverse outcome on the gestational age as well as fetal growth.…”