Periodontal Hastalıklar Erken Doğum ve Düşük Doğum Ağırlığı İçin Bir Risk Faktörü müdür?

Yıl 2023, , 173 - 178, 27.12.2023

Kübra Ceran Deveci , Metin Çalışır , Mehmet Fatih Deveci , Talip Karaçor

https://doi.org/10.51122/neudentj.2023.74

Öz

Amaç: Erken doğum ya da düşük doğum ağırlığı, yenidoğan mortalite ve morbiditesinde önemli bir yer tutmaktadır. Günümüzde hala etyolojisi tam aydınlatılamayan vakalar mevcuttur. Bu çalışmanın amacı, 2017 Dünya Çalıştayı’nda kabul edilen güncel sınıflama sistemini kullanarak, periodontal hastalıkların olumsuz gebelik sonuçları üzerine etkisini değerlendirmektir.
Gereç ve Yöntemler: Bu çalışma; takipleri ve doğumları üniversitemizin tıp fakültesi hastanesi kadın hastalıkları ve doğum anabilim dalında gerçekleştirilen, 172 kadın üzerinde gerçekleştirildi. Tüm bireylerin demografik özellikleri kaydedildi ve laboratuvar değerleri incelendi. Gebelik haftası < 37 hafta olan ve/veya bebek doğum ağırlığı < 2500 gr. olanlar vaka grubu (n=85) oluşturuken, gebelik haftası ≥ 37 hafta olan ve bebek doğum ağırlığı ≥ 2500 gr. olanlar ise kontrol grubunu (n=87) oluşturdu. Periodontal ve radyografik muayeneleri yapılan tüm bireylerin plak indeksi (Pİ), gingival indeksi (Gİ), sondlamada kanama yüzdesi (SK%), sondlama cep derinliği (SCD) ve klinik ataşman seviyesi (KAS) değerleri ölçüldü ve güncel sınıflama sistemine göre tanı konuldu. Periodontal hastalık ile olumsuz gebelik arasındaki ilişkiyi incelemek için iki grup arasıdna analizler yapıldı.
Bulgular: Vaka grubunda; Pİ, Gİ, SK%, ve SCD değerleri kontrol grubuna kıyasla anlamlı olarak yüksek bulundu (p<0.001). Vaka grubunda KAS değeri daha yüksek olmasına rağmen fark anlamlı değildi (p=0.058). Vaka grubunda WBC (p=0.020) ve PLT (p<0.001) değerleri kontrol grubuna kıyasla anlamlı olarak yüksekti.
Sonuç: Bu çalışmanın sonuçlarına göre, periodontal hastalıklar olumsuz gebelik sonuçları ile ilişkilidir. Kadınların gebelik öncesi ve gebelik süresince oral hijyenlerine ve dental muayenelerine dikkat etmeleri gerekmektedir.

Anahtar Kelimeler

Düşük doğum ağırlığı, erken doğum, periodontal hastalıklar, plak indeks, gingival indeks

Destekleyen Kurum

Adıyaman Üniversitesi Bilimsel Araştırma Proje Koordinatörlüğü'

Proje Numarası

DHFDUP/2019-0001

Is Periodontal Disease a Risk Factor for Premature Birth and Low Birth Weight?

Öz

Aim: Premature birth or low birth weight has an important place in neonatal mortality and morbidity. Today, there are still cases whose etiology has not been fully elucidated. The aim of this study is to evaluate the effect of periodontal diseases on adverse pregnancy outcomes by using the current classification system accepted at the 2017 World Workshop.
Materials and Methods: This study was carried out on 172 women who were followed up and delivered in the department of obstetrics and gynecology of our university’s medical faculty hospital. Demographic characteristics of all individuals were recorded and laboratory values were examined. While those with a gestational age <37 weeks and/or baby birth weight < 2500 g were constituted to the case group (n=85), those with a gestational age ≥ 37 weeks and/or baby birth weight ≥ 2500 g constituted the control group (n=87). Clinical periodontal and radiographic evaluations including plaque index (PI), gingival index (GI), bleeding on probing (BOP %), probing pocket depth (PPD) and clinical attachment level (CAL) values were performed for all individuals, and the diagnoses were made by the applied classification system. Analyzes were performed between the two groups to examine the relationship between periodontal disease and adverse pregnancy.
Results: PI, GI, BOP %, and PPD values in the case group were significantly higher compared to the control group (p<0.001). Although the CAL value was higher in the case group, the difference was not significant (p=0.058). WBC (p=0.020) and PLT (p<0.001) values were significantly higher in the case group.
Conclusion: According to the results of this study, periodontal diseases are associated with adverse pregnancy outcomes independent of other risk factors. Women should pay attention to their oral hygiene and dental examinations before and during pregnancy.

Anahtar Kelimeler

low birth weight, preterm birth, periodontal diseases, plaque index, gingival index

Proje Numarası

DHFDUP/2019-0001

Kaynakça

• 1. Tonetti MS, Van Dyke TE, working group 1 of the joint EFP/AAPworkshop. Periodontitis and atherosc-lerotic cardiovascular disease: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases.J Periodontol. 2013;84:24-9.
• 2. Carrillo‐de‐Albornoz A, Figuero E, Herrera D, Bas-cones‐Martínez A. Gingival changes during pregnancy: II. Influence of hormonal variations on the subgingi-val biofilm. J Clin Periodontol. 2010;37:230-40.
• 3. Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol. 2018;89:159-72.
• 4. World Health Organization. The incidence of low birth weight: an update. Weekly Epidemiol Rec 1984:59:205-11.
• 5. World Health Organization. International Classifica-tion of Diseases. 1975 revision. Volume 1. Geneva: WHO, 1977.
• 6. Bey A, Gupta ND, Khan S, Ashfaq N, Hadi SA. Perio-dontitis: a significant risk factor for preterm low birth weight (PTLBW) babies. Biol Med. 2011;3:158-63.
• 7. Dasanayake AP, Boyd D, Madianos PN, Offenbacher S, Hills E. The association between Porphyromonas gingivalis-specific maternal serum IgG and low birth weight. J Periodontol. 2001;72:1491-7.
• 8. Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM,Dommisch H, Eickholz P, et al. Periodontal he-alth and gingival diseases and conditions on an intact and a reduced periodontium: consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Disea-ses and Conditions. J Periodontol. 2018;89:S74-S84.
• 9. Vergnes JN, Sixou M. Preterm low birth weight and maternal periodontal status: a meta-analysis. Am J Obstet Gynecol. 2007;196:135-e1.
• 10. Daalderop LA, Wieland BV, Tomsin K, Reyes L, Kra-mer BW, Vanterpool SF, et al. Periodontal disease and pregnancy outcomes: overview of systematic re-views. JDR Clin Trans Res. 2018;3:10-27.
• 11. Armitage GC. Bi-directional relationship between pregnancy and periodontal disease. Periodontol 2000. 2013;61:160–7.
• 12. Ide M, Papapanou PN. Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes--systematic review.J Periodon-tol 2013;84:181-94.
• 13. Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G, et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol. 1996;67:1103-13.
• 14. Ali T, Abidin K. Relationship of periodontal disease to preterm low birth weight infants in a selected po-pulation- a prospective study. Community Dent He-alth. 2012;29:100-5.
• 15. Borrell L, Papapanou PN. Analytical epidemiology of periodontitis. J Clin Periodontol. 2005;32:132–58.
• 16. Lohana MH,Suragimath G, Patange RP, Varma S, Zope SA. Prospective cohort study to assess and correlate the maternal periodontal status with their pregnancy outcome. J Obstet Gynaecol India. 2017;67:27-32.
• 17. Vettore MV, Leao AT, Leal Mdo C, Feres M, Sheiham A. The relationship between periodontal disease and preterm low birthweight: clinical and microbiologi-cal results. J Periodontal Res. 2008;43:615-26.
• 18. Santos-Pereira SA, Giraldo PC, Saba-Chujfi E, Amaral RL, Morais SS, Fachini AM, et al. Chronic periodonti-tis and pre-term labour in Brazilian pregnant women: an association to be analysed. J Clin Periodontol. 2007;34:208-13.
• 19. Moss KL, Beck JD, Offenbacher S. Clinical risk factors associated with incidence and progression of perio-dontal conditions in pregnant women. J Clin Perio-dontol. 2005;32:492-8.
• 20. Page RC, Eke PI, Case definitions for use in popula-tion‐based surveillance of periodontitis. J periodon-tol. 2007;78:1387-99.
• 21. Lopez NJ, Smith PC, Gutierrez J. Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomized cont-rolled trial. J Periodontol. 2002;73:911-24.
• 22. Jarjoura K, Devine PC, Perez-Delboy A, Herrera-Abreu M, D’Alton M, Papapanou PN. Markers of periodontal infection and preterm birth. American J Obstet Gyne-col. 2005;192:513-19.
• 23. Croce K, Libby P. Intertwining of thrombosis and inf-lammation in atherosclerosis. Curr Opin Hematol. 2007;14:55–61.
• 24. Loos BG, Craandijk J, Hoek FJ, Wertheim-van Dillen PM, Velden UVD. Elevation of systemic markers rela-ted to cardiovascular diseases in the peripheral blood of periodontitis patients. J Periodontol. 2000;71:1528-34.
• 25. Lourbakos A, Yuan YP, Jenkins AL, Travis J, Andrade-Gordon P, Santulli R, et al.Activation of protease-activated receptors by gingipains from Porphyromo-nas gingivalis leads to platelet aggregation: a new trait in microbial pathogenicity. Blood. 2001;97:3790–7.
• 26. AcharyaAB, ShettyIP, JainS, PadakannayaI, AcharyaS, ShettarL Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in chronic periodontitis before and after nonsurgical therapy. J Indian Soc Periodon-tol. 2019;23:419-23.
• 27. Papapanagiotou D, Nicu E, Bizzarro S, Gerdes V, Mei-jers J, Nieuwland R. Periodontitis is associated with platelet activation. Atherosclerosis. 2009;202:605–11.