Periodontal disease and intra-amniotic complications in women with preterm prelabor rupture of membranes

Radochová, Vladimíra; Musilová, Ivana; Štěpán, Martin; Vescicik, Peter; Slezák, Radovan; Jacobsson, Bo; Kacerovský, Marian

doi:10.1080/14767058.2017.1358265

Cited by 11 publications

(6 citation statements)

References 30 publications

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“…The route from maternal mouth to placenta and fetus is consistent with observations by other investigators that, in the human, bacterial DNA in placenta matches that reported in the maternal mouth 26,62,63 , oral bacteria are found in human placenta after preterm birth 23 , and that oral inoculation of the pregnant mouse with P. gingivalis results in detection of that bacteria in the placenta 21 . Bacteria present in the maternal mouth have been observed in the placenta and have been attributed to be associated with preterm birth 23,26 , suggesting that very large numbers of bacteria can cause clinical infection via the same route and stimulate preterm labor. With regard to transfer of bacteria across placenta, we are mindful of the limitation of the animal model that the sheep placenta has a different structure than the human or nonhuman primate placenta.…”

Section: Discussionsupporting

confidence: 90%

Transfer of oral bacteria to the fetus during late gestation

Rodriguez

Paul

et al. 2021

Sci Rep

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The fetus develops in a privileged environment, as the placenta serves as both a gateway for nutrients and a barrier for pathogen transfer to the fetus. Regardless, recent evidence suggests the presence of bacterial DNA in both placenta and fetus, and we have reported that DNA and protein from small numbers of bacteria gain access to the fetus from the maternal bloodstream. Other routes of environmental bacterial transfer from the mother to fetus remain unknown, as well as the physiological relevance of their presence. In these experiments, we examine multiple routes by which bacterial cellular components can enter the fetus and the fetal response to influx of bacterial DNA and protein. We inoculated maternal sheep with genetically-labeled S. aureus (Staphylococcus aureus) using three routes: intravenously, orally, and intra-vaginally. The inoculum did not produce sepsis or fever in the ewes, therefore mimicking incidental exposure to bacteria during pregnancy. 3–5 days post inoculation, we assessed the presence of bacterial components in the fetal tissues and analyzed fetal brain tissue to identify any alterations in gene expression. Our results demonstrate that components of bacteria that were introduced into the maternal mouth were detected in the fetal brain and that they stimulated changes in gene expression. We conclude that an oral route of transmission is relevant for transfer of bacterial cellular components to the fetus.

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Section: Discussionsupporting

confidence: 90%

Transfer of oral bacteria to the fetus during late gestation

Rodriguez

Paul

et al. 2021

Sci Rep

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“…A recent study showed no association between periodontal disease status and microbial invasion of the amniotic cavity (MAIC) and intra-amniotic inflammation (IAI). It is possible that the link between preterm PROM and periodontal disease could be through an exaggerated systemic inflammatory response; however, this requires further investigation 377 .…”

Section: A Common Genetic Substrate For Spontaneous Preterm Labor/birmentioning

confidence: 99%

Spontaneous preterm birth: advances toward the discovery of genetic predisposition

Strauss

Romero

Gomez‐Lopez

et al. 2018

American Journal of Obstetrics and Gynecology

110

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Evidence from family and twin-based studies provide strong support for a significant contribution of maternal and fetal genetics to the timing of parturition and spontaneous preterm birth. However, there has been only modest success in the discovery of genes predisposing to preterm birth, despite increasing sophistication of genetic and genomic technology. In contrast, DNA variants associated with other traits/diseases have been identified. For example, there is overwhelming evidence that suggests that the nature and intensity of an inflammatory response in adults and children are under genetic control. Because inflammation is often invoked as an etiologic factor in spontaneous preterm birth, the question of whether spontaneous preterm birth has a genetic predisposition in the case of pathologic inflammation has been of long-standing interest to investigators. Here, we review various genetic approaches used for the discovery of preterm birth genetic variants in the context of inflammation-associated spontaneous preterm birth. Candidate gene studies have sought genetic variants that regulate inflammation in the mother and fetus; however, the promising findings have often not been replicated. Genome-wide association studies, an approach to the identification of chromosomal loci responsible for complex traits, have also not yielded compelling evidence for DNA variants predisposing to preterm birth. A recent genome-wide association study that included a large number of White women (>40,000) revealed that maternal loci contribute to preterm birth. Although none of these loci harbored genes directly related to innate immunity, the results were replicated. Another approach to identify DNA variants predisposing to preterm birth is whole exome sequencing, which examines the DNA sequence of protein-coding regions of the genome. A recent whole exome sequencing study identified rare mutations in genes encoding for proteins involved in the negative regulation (dampening) of the innate immune response (eg, CARD6, CARD8, NLRP10, NLRP12, NOD2, TLR10) and antimicrobial peptide/proteins (eg, DEFB1, MBL2). These findings support the concept that preterm labor, at least in part, has an inflammatory etiology, which can be induced by pathogens (ie, intraamniotic infection) or "danger signals" (alarmins) released during cellular stress or necrosis (ie, sterile intraamniotic inflammation). These findings support the notion that preterm birth has a polygenic basis that involves rare mutations or damaging variants in multiple genes involved in innate immunity and host defense mechanisms against microbes and their noxious products. An overlap among the whole exome sequencing-identified genes and other inflammatory conditions associated with preterm birth, such as periodontal disease and inflammatory bowel disease, was observed, which suggests a shared genetic substrate for these conditions. We propose that whole exome sequencing, as well as whole genome sequencing, is the most promising approach for the identification of functionally signi...

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“…Women characterized by both microbial invasion of the amniotic cavity and intra-amniotic infection beyond 28 gestational weeks were actively managed: women were treated only with corticosteroids and antibiotics, and either labour was induced or a caesarean section was performed within 72 hr of membrane rupture as previously described Musilova et al, 2016). The remaining women with PPROM at >34 weeks were conservatively managed: labour was induced or an elective caesarean section was Demographic and clinical data, as well as data regarding periodontal status, based on the presence of microbial invasion of the amniotic cavity and/or intra-amniotic inflammation from PPROM cohorts, have been previously published Radochova et al, 2017).…”

Section: Department Of Obstetrics and Gynecology University Hospitalmentioning

confidence: 99%

“…Demographic and clinical data, as well as data regarding periodontal status, based on the presence of microbial invasion of the amniotic cavity and/or intra-amniotic inflammation from PPROM cohorts, have been previously published (Kacerovsky et al, 2017;Radochova et al, 2017).…”

Section: Patients and Me Thodsmentioning

confidence: 99%

Association between periodontal disease and preterm prelabour rupture of membranes

Radochová

Štěpán

Musilová

et al. 2019

J Clinic Periodontology

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Objective Periodontal disease is a possible contributing factor to preterm delivery. The aim of this study was to compare the periodontal status of women with preterm prelabour rupture of membranes (PPROM) and women with uncomplicated singleton pregnancies. Patients and Methods Seventy‐eight women with PPROM at gestational ages between 24 + 0 and 36 + 6 weeks and 77 healthy women with uncomplicated pregnancies, matched for gestational age at sampling without preterm birth, were included in this study. All women underwent evaluation of periodontal and oral hygiene status. Results Women with PPROM had higher gingival and plaque indexes in crude analysis (gingival index: median 0.80 versus 0.20; p < 0.0001; plaque index: median 0.80 versus 0.10; p < 0.0001), even after adjustment for smoking status (p < 0.0001 and p < 0.0001). Mean clinical attachment loss (CAL) and probing pocket depth (PPD) values were higher in women with PPROM in the crude analysis (CAL: median 2.3 mm versus 1.8 mm; p < 0.0001; PPD: median 2.3 mm versus 1.8; p < 0.0001), as well as after adjustment for smoking status (p < 0.0001 and p < 0.0001). Conclusions Pregnant women with PPROM residing in central Europe had worse periodontal status than women with uncomplicated pregnancies.

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Periodontal disease and intra-amniotic complications in women with preterm prelabor rupture of membranes

Abstract: The presence of MIAC and IAI was not related to the periodontal status of women with PPROM.

Cited by 11 publications

References 30 publications

Transfer of oral bacteria to the fetus during late gestation

Transfer of oral bacteria to the fetus during late gestation

Spontaneous preterm birth: advances toward the discovery of genetic predisposition

Association between periodontal disease and preterm prelabour rupture of membranes

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