Periodontitis as a Risk Factor for Adverse Pregnancy Outcomes
A. introduction periodontal disease and adverse pregnancy outcomes
1. Adverse pregnancy outcomes associated with periodontal disease include miscarriage, premature birth, low birth weight, pre-eclampsia.
a. Premature births with low birth weight at birth babies is the leading cause of neonatal mortality and long-term development of the nervous system disorders and health problems in children.
B. Pre-eclampsia is a serious complication of pregnancy characterized by a sharp increase in blood pressure, large amounts of the protein albumin in the urine and swelling of the arms, legs and face. Preeclampsia occurs in the third trimester (last trimester) of pregnancy.
2. Adverse outcomes of pregnancy were associated with risk factors such as Smoking, alcohol consumption, poor diet, urogenital infections, and stress. Prematurity, low birth weight deliveries represent about 10% of annual births in industrialized countries. Of these genera, 25% to happen without known risk factors.
Recent studies have shown that periodontal disease may be a risk factor during pregnancy.
3. The American Academy of Periodontology issued a statement, in 2004, recommending that "women who are pregnant or planning a pregnancy to pass periodontal examinations. Appropriate preventive or curative services, if specified, must be provided. Preventive care of oral cavity services should be provided as early in pregnancy as possible. However, women should be encouraged to achieve a high level of oral hygiene before conception and throughout pregnancy" .
4. The other group, which approved the content of the American Academy of Periodontology statement regarding periodontal management of the pregnant patient, the American College of obstetricians and gynecologists, USA March of dimes, and the American National nurses Association .
B. summary of research
1. The results of several studies suggest an Association between periodontal disease and adverse pregnancy outcomes (box 18-3).
a. Offenbacher et al.  found that women with low body weight at birth were more clinical attachment loss than women with normal body weight at birth of children.
B. Offenbacher et al.  found that periodontits contributed more preterm low birthweight cases than Smoking or alcohol use during pregnancy.
2. Further research is needed to establish the pathogenetic mechanisms of the development of active periodontal disease and subgingival periodontal pathogens associated with gestosis development.
3. Additional research is needed to assess the efficiency and profitability of different types of periodontal intervention on adverse pregnancy outcomes. Three studies with early intervention provide evidence that the periodontal treatment can reduce the likelihood of premature low body weight at birth babies [44-46]. One study has shown that periodontal treatment did not significantly alter the rates of premature birth or birth of a baby with low birth weight .
4. Currently, the U.S. National Institute of dental and craniofacial research (NIDCR) has made significant investments in research on this topic with $20 million research project, which includes two independent international multi-center clinical trials involving approximately 2600 pregnant women.
C. Possible Biological Explanation. As Periodontits associated with adverse pregnancy Outcomes? Animal studies suggest that reservoir gram-negative organisms, such as those contained in periodontitis may have a negative impact on pregnancy outcome (Fig. Sheet 18-5).
D. implications for dental hygiene. Of dental hygienists should inform patients about the Association between adverse pregnancy outcomes and periodontal infection and the start of the service, for oral hygiene for pregnant women and those who are considering pregnancy. Understanding the mechanism of periodontal associated with adverse pregnancy outcomes can lead to interventions aimed at improving growth of the fetus.