Periodontitis & Pregnancy Outcomes
Periodontitis is an oral infection in which the associated pathogens lead to systemic inflammation. The inflammatory process is strongly implicated in preeclampsia which is a leading cause of pregnancy complications, affecting 3-7% of pregnant women. The red complex bacteria involved with periodontal disease initiate profound intracellular damage that plays a part in many systemic diseases including adverse pregnancy and neonatal outcomes. Pregnant women are particularly susceptible to the immune-inflammatory response to periodontal infection due to the increased sensitivity of their immune system and to the increase in hormones. The immune-inflammatory response is responsible for the release of cytokines which result in systematic inflammation allowing bacteria to move from the site of infection to the bloodstream and into chorionic tissue. C-reactive proteins, free radicals, and prostaglandin E2 are additional chemicals produced during the inflammatory response that have negative consequences for pregnancies. In addition, there is a link between periodontitis and metabolic syndrome in which over 50% of of women with MetS during early pregnancy developed complications. Lastly, periodontal disease is thought to contribute to infertility by delaying conception.