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      La periodontitis como factor de riesgo de preeclampsia

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          Abstract

          Objetivo: Conocer si la periodontitis es un factor de riesgo en la aparición de la preeclampsia y si la proteína C reactiva es el mediador inflamatorio de este fenómeno. Método: Se realizó un estudio de diseño de caso-control. Se agruparon las pacientes en dos grupos, el primero embarazadas con preeclampsia (grupo de casos n=20) y embarazadas sin preeclampsia (grupo control n= 30) y luego se investigó en ambos la presencia y exposición al factor de riesgo (periodontitis) y los niveles de proteína C reactiva. Resultados: Se determinó que el 80 % de las pacientes presentaban periodontitis crónica, mientras que el 20 % restante fueron diagnosticadas con gingivitis del embarazo. De las pacientes diagnosticadas con preeclampsia, 15 presentaron periodontitis crónica; mientras que de las 30 embarazadas sanas, 25 presentaron dicha patología. En la muestra estudiada no existe evidencia estadística de relación entre las variables preeclampsia y periodontitis (OR 0,6; IC 95 % 0,148-2,421). Los niveles promedio de la proteína C reactiva en los grupos de estudio no revelaron diferencias estadísticamente significativas. Conclusiones: No existe relación directa entre la presencia de periodontitis crónica y el riesgo de desarrollar preeclampsia; ya que tanto en las pacientes preeclámpticas como en las no preeclámpticas hubo presencia de periodontitis crónica, sin diferencias estadísticas significativas. No se logró determinar totalmente el papel de la proteína C-reactiva.

          Translated abstract

          Objective: To know if periodontitis is a risk factor for developing preeclamsia during pregnancy and to determine if C reactive protein plays a role as an inflamatory mediator in this condition. Method: A case control study was performed with to groups of patients. One group was pregnant patients with preeclamsia (cases n=20), the other pregnant without preeclampsia (control n=30), periodontitis and C reactive protein was assessed in both groups. Results: Of the total of the patients 80 % had chronic periodontitis while 20 % had pregnacy gingivitis. 15 patients of the preeclampsia group had chronic periodontitis, while 25 patients of the control group had chronic periodontitis (OR 0,6; IC 95 % 0,148-2,421). Levels of C reactive protein show no difference between groups. Conclusions: No relation between chronic periodontitis and the risk of developing preeclampsia was found. Significance of high levels of C reactive protein was not assessed in preeclamptic patients.

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          Periodontal infection as a possible risk factor for preterm low birth weight.

          Peridontal diseases are gram-negative anaerobic infections that can occur in women of childbearing age (18 to 34 years). In the present investigation we sought to determine whether the prevalence of maternal periodontal infection could be associated with preterm low birth weight (PLBW), controlling for known risk factors and potential covariates. A case-control study of 124 pregnant or postpartum mothers was performed. PLBW cases were defined as a mother with a birth of less than 2,500 g and one or more of the following: gestational age < 37 weeks, preterm labor (PTL), or premature rupture of membranes (PROM). Controls were normal birth weight infants (NBW). Assessments included a broad range of known obstetric risk factors, such as tobacco use, drug use, alcohol consumption, level of prenatal care, parity, genitourinary infections, and nutrition. Each subject received a periodontal examination to determine clinical attachment level. PLBW cases and primiparous PLBW cases (n = 93) had significantly worse periodontal disease than the respective NBW controls. Multivariate logistic regression models, controlling for other risk factors and covariates, demonstrated that periodontal disease is a statistically significant risk factor for PLBW with adjusted odds ratios of 7.9 and 7.5 for all PLBW cases and primiparous PLBW cases, respectively. These data indicate that periodontal diseases represent a previously unrecognized and clinically significant risk factor for preterm low birth weight as a consequence of either PTL or preterm PROM.
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            Influence of hormonal variation on the periodontium in women.

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              A prospective study to investigate the relationship between periodontal disease and adverse pregnancy outcome.

              This study aimed to investigate a relationship between maternal periodontal disease and preterm birth, low birth weight and late miscarriage. Prospective study in a single centre. Guy's and St Thomas' Hospital Trust, London, UK between August 1998 and July 2001. Pregnant women were recruited on attending an ultrasound scan at approximately 12 weeks of pregnancy. Subjects completed a questionnaire and underwent periodontal examination. Plaque and bleeding scores, pocket probing depth and loss of attachment. Pregnancy outcome data was collected retrospectively, including gestational age and birth weight at delivery. Data were collected for 3,738 subjects. Regression analysis indicated that there were no significant relationships between the severity of periodontal disease and either preterm birth (PTB) or low birth weight (LBW). In contrast, there did appear to be a correlation between poorer periodontal health and those that experienced a late miscarriage. There was no association between either preterm birth or low birth weight and periodontal disease in this population. There is evidence of a correlation between markers of poorer periodontal health and late miscarriage.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                og
                Revista de Obstetricia y Ginecología de Venezuela
                Rev Obstet Ginecol Venez
                Sociedad de Obstetricia y Ginecología de Venezuela (Caracas )
                0048-7732
                June 2013
                : 73
                : 2
                : 80-87
                Affiliations
                [1 ] Universidad de Los Andes Venezuela
                Article
                S0048-77322013000200002
                50c83c79-0a99-42af-b9d1-cc00d636b612

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0048-7732&lng=en
                Categories
                OBSTETRICS & GYNECOLOGY

                Obstetrics & Gynecology
                Periodontal disease,Preeclampsia,Periodontitis,Enfermedad periodontal
                Obstetrics & Gynecology
                Periodontal disease, Preeclampsia, Periodontitis, Enfermedad periodontal

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