Microbiologic and Inflammatory Markers of Periodontitis are Different to those of Preterm Birth

Abstract

Citation: Lumbreras Areta M, Gayet-Ageron A, Roux-Lombard P, Schrenzel J, AbstractBackground: Comparing microbiologic and inflammatory markers of periodontitis with those of preterm birth (PTB).Methods: Secondary analysis of a prior prospective case-control study done at the Geneva University Hospitals. Cases were women delivering at 22-34 6/7 weeks (early PTB, n=30) and controls were women delivering at ≥ 37 weeks (term delivery, n=87). We collected dental plaque during labour to quantify RNA levels from Aggregatibacter actinomycetemcomitans (Aa), Tannerella forsythia (Tf), Porphyromonas gingivalis (Pg) and Treponema denticola (Td). We also collected cord blood for cultures and cytokine quantification (IL-1Ra, IL-6, IL-8, IL-10, IL-17, TNF-α, MCP-1 and RANTES). Periodontal status was evaluated at the immediate postpartum using the American Consensus definition. Data was analysed by univariate and multivariate logistic regression.Results: Levels of Pg and Td were significantly higher in dental plaque of women with severe and moderate periodontitis. Microbiologic composition of dental plaque was not different between preterm and term delivery groups. There were no differences in cord blood cultures between groups. Cord TNF-α ≥ 8 pg/ml and IL-10 ≥ 1.3 pg/ml were associated with a higher risk of periodontitis (OR 2.78, 95% CI: 1.09-7.13, P=0.033; OR 2.78, 95% CI: 1.09-7.08, P=0.032 respectively), but differences were not significant at multivariate analysis. Cord MCP-1 ≥ 350 pg/ml was associated with a higher risk of PTB at both univariate (OR 40.25, P<0.001) and multivariate analysis (OR 53.71, P<0.001). Conclusion:In labour, microbiologic markers and inflammatory responses associated with periodontitis and PTB are different. The mechanisms linking periodontitis and PTB therefore still need to be elucidated. Page 2 of 9Citation: Lumbreras Areta M, Gayet-Ageron A, Roux-Lombard P, Schrenzel J, 2.38, 95% CI: 1.36-4.14, P=0.002) [20]. In this secondary analysis, we aim to compare the type of bacteria (in dental plaque and cord blood) and cytokines/chemokines (in cord blood) in women with severe periodontitis with those in women with early PTB. The objective is to determine if the microbiological and/or inflammatory pathways in periodontitis are the same as those involved in early PTB. A shared molecular pathway would explain the aetiology of the association between periodontitis and increased risk of PTB that was observed in our previous study. Methods Study designThis is a planned secondary analysis of women included in a prior prospective case-control (1:4) study performed between 09 November, 2007 and 18 March, 2010 at the maternity unit of the Geneva University Hospitals, Switzerland [20]. Briefly, the study evaluated the association of periodontitis in cases (women delivering spontaneously between 22 and 34, 6/7 weeks of gestation) compared to controls (women delivering as term [≥ 37 weeks]). The study was approved by the Ethics Committee of Geneva (study number 07-008, approved 28 March 2007). All partic...