Increased infection with key periodontal pathogens during gestational diabetes mellitus

• Published in: Journal of clinical periodontology Vol. 42; no. 6; pp. 506 - 512
• Main Authors: Gogeneni, Himabindu, Buduneli, Nurcan, Ceyhan-Öztürk, Banu, Gümüş, Pınar, Akcali, Aliye, Zeller, Iris, Renaud, Diane E., Scott, David A., Özçaka, Özgün
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.06.2015
• Subjects: Adult; Bacteria, Anaerobic - isolation & purification; Biomarkers - blood; C-Reactive Protein - analysis; Case-Control Studies; Cotinine - analysis; CRP; Dental Plaque Index; Diabetes, Gestational - blood; Diabetes, Gestational - microbiology; Female; gestational diabetes; gingivitis; Gingivitis - blood; Gingivitis - microbiology; Gram-Positive Bacteria - isolation & purification; Humans; Periodontal Index; Periodontal Pocket - classification; periodontopathogens; Porphyromonas gingivalis - isolation & purification; Pregnancy; Pregnancy Complications, Infectious - blood; Pregnancy Complications, Infectious - microbiology; Pregnancy Outcome; Saliva - chemistry; Saliva - microbiology; Treponema denticola - isolation & purification; Young Adult; CRP; gingivitis; periodontopathogens; gestational diabetes; pregnancy
• ISSN: 0303-6979; 1600-051X
• DOI: 10.1111/jcpe.12418

Aim Gestational diabetes mellitus (GDM), gingivitis, infection with specific periodontal pathogens and systemic inflammation each increase the risk for poor pregnancy outcome. We set out to monitor the interactions of gingivitis and GDM with respect to oral infection and the systemic inflammatory burden. Materials and Methods Four case–control groups (n = 117) were recruited, (1) No gingivitis, No GDM (n = 27); (2) Gingivitis, No GDM (n = 31); (3) No gingivitis, GDM (n = 21); and (4) Gingivitis, GDM (n = 38). Oral infection with three key periodontal pathogens was determined by PCR. Systemic inflammation was determined by quantification of CRP by EIA. Results Gingivitis during pregnancy was associated with oral infection with Porphyromonas gingivalis, Filifactor alocis and Treponema denticola and combinations thereof (all p < 0.01). GDM was also associated with increased infection with individual and multiple oral pathogens (all p < 0.05). Gingivitis during pregnancy led to a 325% increase in systemic CRP (mean, 2495 versus 8116 ng/ml, p < 0.01). Conclusions Diabetes and gingivitis act in concert to increase risk biomarkers for poor pregnancy outcome.