American Journal of Obstetrics and Gynecology
Transactions of the Twenty-Fifth Annual Meeting of the Society for Maternal-Fetal MedicineFetal immune response to oral pathogens and risk of preterm birth
Section snippets
Materials and methods
The Oral Conditions and Pregnancy study was a prospective, observational study designed to study maternal oral health in pregnancy and association with adverse pregnancy outcomes. Detailed methodology has been published elsewhere.1 Briefly, 1115 women were enrolled at <26 weeks' gestation. A systematic dental examination, maternal oral, vaginal, and blood specimens were collected and demographic and medical data recorded. At delivery, 10 to 20 mL of mixed arterial and venous umbilical cord was
Results
Of 1115 women enrolled in the Oral Conditions and Pregnancy study, 640 (57.4%) had umbilical cord blood collected and complete information available. Of these 640, 48 (7.5%) delivered preterm (<35 weeks). The mean, median, and range of serum inflammatory markers for the study cohort, and stratified by delivery <35 or ≥35 weeks' are shown in Table I. Increasing levels of umbilical cord serum C-reactive protein and TNF-α were associated with delivery <35 weeks' gestation (OR, 95% CI 1.8, 1.3-2.5
Comment
Our study demonstrates that fetal exposure to oral pathogens evidenced by an IgM response is associated with preterm birth at <35 weeks. Fetuses with high TNF-α or 8-isoprostane levels also demonstrate an increased risk for preterm birth, independent of fetal IgM response. Previous studies have demonstrated that a fetal inflammatory response, evidenced by umbilical cord levels of TNF-α, IL-6, or C-reactive protein, is associated with preterm birth.10, 11, 12 Our study is the first to
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2013, Archives of Oral BiologyCitation Excerpt :Tumour necrosis factor (TNF)-α, interleukin (IL)-1, and IL-6 are commonly associated with oral infections involving both periodontal1–9 and periapical10,11 tissues.
Supported by K08 HD043284 (K. A. B.), R01 DE12453 (S. O.), and the University of North Carolina General Clinical Research Center grant RR00046.
Presented at the Twenty-Fifth Annual Meeting of the Society for Maternal Fetal Medicine, February 7-12, 2005, Reno, Nev.