Hamilelik ve periodontal hastalık
Yıl 2014,
Cilt: 4 Sayı: 4, 261 - 267, 03.05.2015
Ebru Sağlam
,
Nesrin Saruhan
Cenk Fatih Çanakçı
Öz
Hamileliğe bağlı olarak annede görülen bazı immünolojik değişiklikler enfeksiyonlara yatkınlığı artırmaktadır. Periodontal hastalık, başlıca sebebi mikrobiyal dental plak olan, multifaktöriyel ve çeşitli şiddetlerde görülen yaygın bir hastalıktır. Periodontal hastalığın klinik olarak birçok tanı kriteri bulunmaktadır. Hamilelik ve periodontal enflamasyon arasındaki ilişki uzun yıllardır bilinmektedir. Periodontal hastalık, hamilelerde sistemik durumu etkilemektedir ve fetusa da olumsuz etkileri bulunmaktadır. Periodontal hastalık, erken doğum ve düşük doğum ağırlığı riskini artırmaktadır. Bu derlemenin amacı hamilelik ve periodontal hastalık arasındaki çift yönlü etkileşimi bilimsel bulgular ışığında değerlendirmektir.
Kaynakça
- Boggess KA. Maternal oral health in pregnancy. Obstet Gynecol. 2008; 111(4): 976-986.
- Polyzos NP, Polyzos IP, Zavos A, Valachis A, Mauri D, Papanikolaou EG, Tzioras S, Weber D, Messinis IE. Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis. BMJ. 2010;341: c7017.
- Haram K, Mortensen JH, Wollen AL. Preterm delivery: an overview. Acta Obstet Gynecol Scand. 2003; 82(8): 687-704.
- Madianos PN, Bobetsis YA, Offenbacher S. Adverse pregnancy outcomes (APOs) and periodontal disease: pathogenic mechanisms. J Periodontol. 2013; 84(4): 170-180.
- Beer AE, Billingham RE. Immunobiology of mammalian reproduction. Adv Immunol. 1971; 14: 1-84.
- Medawar PB. Some immunological and endocrinological problems raised by the evolution of viviparity in vertebrates. Symp Soc Exp Biol. 1953; 7: 320-328.
- Poole JA, Claman HN. Immunology of pregnancy. Implications for the mother. Clin Rev Allergy Immunol. 2004; 26(3): 161-170.
- Jamieson DJ, Theiler RN, Rasmussen SA. Emerging infections and pregnancy. Emerg Infect Dis. 2006; 12(11): 1638-1643.
- Singh N, Perfect JR. Immune reconstitution syndrome and exacerbation of infections after pregnancy. Clin Infect Dis. 2007; 45(9): 1192-1199.
- Ehring GR, Kerschbaum HH, Eder C, Neben AL, Fanger CM, Khoury RM, Negulescu PA, Cahalan MD. A nongenomic mechanism for progesterone-mediated immunosuppression: inhibition of K+ channels, Ca2+ signaling, and gene expression in T lymphocytes. J Exp Med. 1998; 188(9): 1593-1602.
- Kanda N, Watanabe S. Regulatory roles of sex hormones in cutaneous biology and immunology. J Dermatol Sci. 2005; 38(1): 1-7.
- Song XY, Zeng L, Jin W, Pilo CM, Frank ME, Wahl SM. Suppression of streptococcal cell wall-induced arthritis by human chorionic gonadotropin. Arthritis Rheum. 2000; 43(9): 2064-2072.
- Belcher C, Doherty M, Crouch SP. Synovial fluid neutrophil function in RA: the effect of pregnancy associated proteins. Ann Rheum Dis. 2002; 61(4): 379-380.
- El-Maallem H, Fletcher J. Impaired neutrophil function and myeloperoxidase deficiency in pregnancy. Br J Haematol. 1980; 44(3): 375-381.
- Kaaja RJ, Greer IA. Manifestations of chronic disease during pregnancy. JAMA. 2005; 294: 2751-2757.
- Özer Ö, Demiralp B. Periodontitis kardiyovasküler hastalığa neden olur mu? Ata Üni Diş Hek Fak Derg, 2005; 15:62-70.
- Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet. 2005; 366(9499): 1809-1820.
- Offenbacher S, Barros SP, Beck JD. Rethinking periodontal inflammation. J Periodontol. 2008; 79(8): 1577-1584.
- Loos BG. Systemic markers of inflammation in periodontitis. J Periodontol. 2005; 76(11): 2106-2115.
- Kunnen A, van Doormaal JJ, Abbas F, Aarnoudse JG, van Pampus MG, Faas MM. Periodontal disease and pre-eclampsia: a systematic review. J Clin Periodontol. 2010; 37(12): 1075-1087.
- Scannapieco FA. Periodontal inflammation: from gingivitis to systemic disease? Compend Contin Educ Dent. 2004; 25(7): 16-25.
- Armitage GC. Bi-directional relationship between pregnancy and periodontal disease. Periodontol 2000. 2013; 61(1): 160-176.
- Jafarzadeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: a review. J Oral Sci. 2006; 48(4): 167-175.
- Silk H, Douglass AB, Douglass JM, Silk L. Oral health during pregnancy. Am Fam Physician, 2008, 77: 1139-1144.
- Figuero E, Carrillo-de-Albornoz A, Martin C, Tobias A, Herrera D. Effect of pregnancy on gingival inflammation in systemically healthy women: a systematic review. J Clin Periodontol. 2013; 40(5): 457-473.
- Machado FC, Cesar DE, Assis AV, Diniz CG, Ribeiro RA. Detection and enumeration of periodontopathogenic bacteria in subgingival biofilm of pregnant women. Braz Oral Res. 2012; 26(5): 443-449.
- Newman M, Takei H, Klokkevold P, Carranza F. Carranza’s Clinical Periodontology 11th edition St. Louis: Mosby 2012: 414- 418.
- Otomo-Corgel J, Pucher JJ, Rethman MP, Reynolds MA. State of the science: chronic periodontitis and systemic health. J Evid Based Dent Pract. 2012; 12(3): 20-28.
- Wiener RC, Wiener-Pla R. Literacy, pregnancy and potential oral health changes: the internet and readability levels. Matern Child Health J. 2014; 18(3): 657-662.
- Bodur S, Özcan E, Gün İ. Gebeliğin periodontal hastalığı: gingivanın hamilelik tümörü. Perinatoloji Derg. 2010; 18(2): 55-58.
- Cruz LE, Martos J. Granuloma gravidarum (pyogenic granuloma) treated with periodontal plastic surgery. Int J Gynaecol Obstet. 2010; 109(1): 73-74.
- Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G, McKaig R, Beck J. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol. 1996; 67(10): 1103-1113.
- Kim J, Amar S. Periodontal disease and systemic conditions: a bidirectional relationship. Odontology. 2006; 94(1): 10-21.
- Ide M, Papapanou PN. Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes-systematic review. J Clin Periodontol. 2013; 40(14):181-194.
- Rosa MI, Pires PD, Medeiros LR, Edelweiss MI, Martinez-Mesa J. Periodontal disease treatment and risk of preterm birth: a systematic review and meta-analysis. Cad Saude Publica. 2012; 28(10): 1823-1833.
- Dasanayake AP. Scaling and root planing performed on pregnant women with mild to moderate periodontal disease is not efficacious in reducing preterm birth, low birth weight, or other poor pregnancy outcomes. J Evid Based Dent Pract. 2012; 12(3): 135-137.
- Shanthi V, Vanka A, Bhambal A, Saxena V, Saxena S, Kumar SS. Association of pregnant women periodontal status to preterm and low-birth weight babies: A systematic and evidence-based review. Dent Res J (Isfahan). 2012; 9(4): 368-380.
- Oppermann RV, Weidlich P, Musskopf ML. Periodontal disease and systemic complications. Braz Oral Res. 2012; 26 (1): 39-47.
- Lin D, Moss K, Beck JD, Hefti A, Offenbacher S. Persistently high levels of periodontal pathogens associated with preterm pregnancy outcome. J Periodontol. 2007; 78(5): 833-841.
- Cruz SI HD, Martin C, Herrero A, Sanz M. Association between periodontal status and pre-term and/or low-birth weight in Spain: clinical and microbiological parameters. J Periodontal Res. 2013; 48(4): 443-451.
- Offenbacher S, Jared HL, O’Reilly PG, Wells SR, Salvi GE, Lawrence HP, Socransky SS, Beck JD. Potential pathogenic mechanisms of periodontitis associated pregnancy complications. Ann Periodontol. 1998; 3(1): 233-250.
- Otenio CC, Fonseca I, Martins MF, Ribeiro LC, Assis NM, Ferreira AP, Ribeiro RA. Expression of IL-1beta, IL-6, TNF-alpha, and iNOS in pregnant women with periodontal disease. Genet Mol Res. 2012; 11(4): 4468-4478.
- Hill GB. Preterm birth: associations with genital and possibly oral microflora. Ann Periodontol. 1998; 3(1): 222-232.
- Xiong X, Buekens P, Vastardis S, Yu SM. Periodontal disease and pregnancy outcomes: state-of-the-science. Obstet Gynecol Surv. 2007; 62(9): 605-615.
- Roberts JM, Pearson G, Cutler J, Lindheimer M. Summary of the NHLBI Working Group on Research on Hypertension During Pregnancy. Hypertension. 2003; 41(3): 437-445.
- Lam C, Lim KH, Karumanchi SA. Circulating angiogenic factors in the pathogenesis and prediction of preeclampsia. Hypertension. 2005; 46(5): 1077-1085.
- Redman CW, Sargent IL. Latest advances in understanding preeclampsia. Science. 2005; 308(5728): 1592-1594.
- Pralhad S, Thomas B, Kushtagi P. Periodontal disease and pregnancy hypertension: a clinical correlation. J Periodontol. 2013; 84(8): 1118- 1125.
- Wei BJ, Chen YJ, Yu L, Wu B. Periodontal disease and risk of preeclampsia: a meta-analysis of observational studies. PLoS One. 2013; 8(8): e70901.
- Canakci V, Canakci CF, Canakci H, Canakci E, Cicek Y, Ingec M, Ozgoz M, Demir T, Dilsiz A, Yagiz H. Periodontal disease as a risk factor for pre-eclampsia: a case control study. Aust N Z J Obstet Gynaecol. 2004; 44(6): 568-573.
- Walker JJ. Pre-eclampsia. Lancet. 2000; 356(9237): 1260-1265.
- Roberts JM, Gammill HS. Preeclampsia: recent insights. Hypertension. 2005; 46(6): 1243-1249.
- Chavarria ME, Lara-Gonzalez L, Garcia-Paleta Y, Vital-Reyes VS, Reyes A. Adhesion molecules changes at 20 gestation weeks in pregnancies complicated by preeclampsia. Eur J Obstet Gynecol Reprod Biol. 2008; 137(2): 157-164.
- Van Nieuwenhoven AL, Moes H, Heineman MJ, Santema J, Faas MM. Cytokine production by monocytes, NK cells, and lymphocytes is different in preeclamptic patients as compared with normal pregnant women. Hypertens Pregnancy. 2008; 27(3): 207-224.
- Chaparro A, Sanz A, Quintero A, Inostroza C, Ramirez V, Carrion F, Figueroa F, Serra R, Illanes SE. Increased inflammatory biomarkers in early pregnancy is associated with the development of pre-eclampsia in patients with periodontitis: a case control study. J Periodontal Res. 2013; 48(3): 302-307.
- Canakci V, Canakci CF, Yildirim A, Ingec M, Eltas A, Erturk A. Periodontal disease increases the risk of severe pre-eclampsia among pregnant women. J Clin Periodontol. 2007; 34(8): 639-645.
- Xie Y, Xiong X, Elkind-Hirsch KE, Pridjian G, Maney P, Delarosa RL, Buekens P. Change of periodontal disease status during and after pregnancy. J Periodontol. 2013; 84(6): 725-731.
- Dasanayake AP, Chhun N, Tanner AC, Craig RG, Lee MJ, Moore AF, Norman RG. Periodontal pathogens and gestational diabetes mellitus. J Dent Res. 2008; 87(4): 328-333.
- Chokwiriyachit A, Dasanayake AP, Suwannarong W, Hormdee D, Sumanonta G, Prasertchareonsuk W, Wara-Aswapati N, Combellick J, Pitiphat W. Periodontitis and gestational diabetes mellitus in non- smoking females. J Periodontol. 201; 84(7): 857-862.
- Chanprapaph P, Sutjarit C. Prevalence of gestational diabetes mellitus (GDM) in women screened by glucose challenge test (GCT) at Maharaj Nakorn Chiang Mai Hospital. J Med Assoc Thai. 2004; 87(10): 1141-1146.
- Serirat S, Deerochanawong C, Sunthornthepvarakul T, Jinayon P. Gestational diabetes mellitus. J Med Assoc Thai. 1992; 75(6): 315-319.
- Habib FA. Evaluation of periodontal status among saudi females with gestational diabetes and its relation to glucose and lipid homeostasis in ohud hospital, Al madina Al-munwarrah. Int J Health Sci (Qassim). 2009; 3(2): 143-154.
- Xiong X, Buekens P, Goldenberg RL, Offenbacher S, Qian X. Optimal timing of periodontal disease treatment for prevention of adverse pregnancy outcomes: before or during pregnancy? Am J Obstet Gynecol. 2011; 205(2): 111 e1-6.
- Iams JD, Romero R, Culhane JF, Goldenberg RL. Primary, secondary, and tertiary interventions to reduce the morbidity and mortality of preterm birth. Lancet. 2008; 371(9607): 164-175.
Pregnancy and periodontal disease
Yıl 2014,
Cilt: 4 Sayı: 4, 261 - 267, 03.05.2015
Ebru Sağlam
,
Nesrin Saruhan
Cenk Fatih Çanakçı
Öz
Some maternal immunological changes due to pregnancy increases susceptibility to infections. Periodontal disease, the main cause is plaque, is a common disease which is seen multifactorial and varying severity. There are many clinical criteria for diagnosis of periodontal disease. Correlation between pregnancy and periodontal inflammation is known for many years. Periodontal disease affects pregnant’s systemic condition and also has negative effects on fetus. Periodontal disease increases the risk of preterm birth and low birth-weight baby. The purpose of this review, bi-directional interaction between pregnancy and periodontal disease is to evaluate in the light of scientific findings.
Kaynakça
- Boggess KA. Maternal oral health in pregnancy. Obstet Gynecol. 2008; 111(4): 976-986.
- Polyzos NP, Polyzos IP, Zavos A, Valachis A, Mauri D, Papanikolaou EG, Tzioras S, Weber D, Messinis IE. Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis. BMJ. 2010;341: c7017.
- Haram K, Mortensen JH, Wollen AL. Preterm delivery: an overview. Acta Obstet Gynecol Scand. 2003; 82(8): 687-704.
- Madianos PN, Bobetsis YA, Offenbacher S. Adverse pregnancy outcomes (APOs) and periodontal disease: pathogenic mechanisms. J Periodontol. 2013; 84(4): 170-180.
- Beer AE, Billingham RE. Immunobiology of mammalian reproduction. Adv Immunol. 1971; 14: 1-84.
- Medawar PB. Some immunological and endocrinological problems raised by the evolution of viviparity in vertebrates. Symp Soc Exp Biol. 1953; 7: 320-328.
- Poole JA, Claman HN. Immunology of pregnancy. Implications for the mother. Clin Rev Allergy Immunol. 2004; 26(3): 161-170.
- Jamieson DJ, Theiler RN, Rasmussen SA. Emerging infections and pregnancy. Emerg Infect Dis. 2006; 12(11): 1638-1643.
- Singh N, Perfect JR. Immune reconstitution syndrome and exacerbation of infections after pregnancy. Clin Infect Dis. 2007; 45(9): 1192-1199.
- Ehring GR, Kerschbaum HH, Eder C, Neben AL, Fanger CM, Khoury RM, Negulescu PA, Cahalan MD. A nongenomic mechanism for progesterone-mediated immunosuppression: inhibition of K+ channels, Ca2+ signaling, and gene expression in T lymphocytes. J Exp Med. 1998; 188(9): 1593-1602.
- Kanda N, Watanabe S. Regulatory roles of sex hormones in cutaneous biology and immunology. J Dermatol Sci. 2005; 38(1): 1-7.
- Song XY, Zeng L, Jin W, Pilo CM, Frank ME, Wahl SM. Suppression of streptococcal cell wall-induced arthritis by human chorionic gonadotropin. Arthritis Rheum. 2000; 43(9): 2064-2072.
- Belcher C, Doherty M, Crouch SP. Synovial fluid neutrophil function in RA: the effect of pregnancy associated proteins. Ann Rheum Dis. 2002; 61(4): 379-380.
- El-Maallem H, Fletcher J. Impaired neutrophil function and myeloperoxidase deficiency in pregnancy. Br J Haematol. 1980; 44(3): 375-381.
- Kaaja RJ, Greer IA. Manifestations of chronic disease during pregnancy. JAMA. 2005; 294: 2751-2757.
- Özer Ö, Demiralp B. Periodontitis kardiyovasküler hastalığa neden olur mu? Ata Üni Diş Hek Fak Derg, 2005; 15:62-70.
- Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet. 2005; 366(9499): 1809-1820.
- Offenbacher S, Barros SP, Beck JD. Rethinking periodontal inflammation. J Periodontol. 2008; 79(8): 1577-1584.
- Loos BG. Systemic markers of inflammation in periodontitis. J Periodontol. 2005; 76(11): 2106-2115.
- Kunnen A, van Doormaal JJ, Abbas F, Aarnoudse JG, van Pampus MG, Faas MM. Periodontal disease and pre-eclampsia: a systematic review. J Clin Periodontol. 2010; 37(12): 1075-1087.
- Scannapieco FA. Periodontal inflammation: from gingivitis to systemic disease? Compend Contin Educ Dent. 2004; 25(7): 16-25.
- Armitage GC. Bi-directional relationship between pregnancy and periodontal disease. Periodontol 2000. 2013; 61(1): 160-176.
- Jafarzadeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: a review. J Oral Sci. 2006; 48(4): 167-175.
- Silk H, Douglass AB, Douglass JM, Silk L. Oral health during pregnancy. Am Fam Physician, 2008, 77: 1139-1144.
- Figuero E, Carrillo-de-Albornoz A, Martin C, Tobias A, Herrera D. Effect of pregnancy on gingival inflammation in systemically healthy women: a systematic review. J Clin Periodontol. 2013; 40(5): 457-473.
- Machado FC, Cesar DE, Assis AV, Diniz CG, Ribeiro RA. Detection and enumeration of periodontopathogenic bacteria in subgingival biofilm of pregnant women. Braz Oral Res. 2012; 26(5): 443-449.
- Newman M, Takei H, Klokkevold P, Carranza F. Carranza’s Clinical Periodontology 11th edition St. Louis: Mosby 2012: 414- 418.
- Otomo-Corgel J, Pucher JJ, Rethman MP, Reynolds MA. State of the science: chronic periodontitis and systemic health. J Evid Based Dent Pract. 2012; 12(3): 20-28.
- Wiener RC, Wiener-Pla R. Literacy, pregnancy and potential oral health changes: the internet and readability levels. Matern Child Health J. 2014; 18(3): 657-662.
- Bodur S, Özcan E, Gün İ. Gebeliğin periodontal hastalığı: gingivanın hamilelik tümörü. Perinatoloji Derg. 2010; 18(2): 55-58.
- Cruz LE, Martos J. Granuloma gravidarum (pyogenic granuloma) treated with periodontal plastic surgery. Int J Gynaecol Obstet. 2010; 109(1): 73-74.
- Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G, McKaig R, Beck J. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol. 1996; 67(10): 1103-1113.
- Kim J, Amar S. Periodontal disease and systemic conditions: a bidirectional relationship. Odontology. 2006; 94(1): 10-21.
- Ide M, Papapanou PN. Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes-systematic review. J Clin Periodontol. 2013; 40(14):181-194.
- Rosa MI, Pires PD, Medeiros LR, Edelweiss MI, Martinez-Mesa J. Periodontal disease treatment and risk of preterm birth: a systematic review and meta-analysis. Cad Saude Publica. 2012; 28(10): 1823-1833.
- Dasanayake AP. Scaling and root planing performed on pregnant women with mild to moderate periodontal disease is not efficacious in reducing preterm birth, low birth weight, or other poor pregnancy outcomes. J Evid Based Dent Pract. 2012; 12(3): 135-137.
- Shanthi V, Vanka A, Bhambal A, Saxena V, Saxena S, Kumar SS. Association of pregnant women periodontal status to preterm and low-birth weight babies: A systematic and evidence-based review. Dent Res J (Isfahan). 2012; 9(4): 368-380.
- Oppermann RV, Weidlich P, Musskopf ML. Periodontal disease and systemic complications. Braz Oral Res. 2012; 26 (1): 39-47.
- Lin D, Moss K, Beck JD, Hefti A, Offenbacher S. Persistently high levels of periodontal pathogens associated with preterm pregnancy outcome. J Periodontol. 2007; 78(5): 833-841.
- Cruz SI HD, Martin C, Herrero A, Sanz M. Association between periodontal status and pre-term and/or low-birth weight in Spain: clinical and microbiological parameters. J Periodontal Res. 2013; 48(4): 443-451.
- Offenbacher S, Jared HL, O’Reilly PG, Wells SR, Salvi GE, Lawrence HP, Socransky SS, Beck JD. Potential pathogenic mechanisms of periodontitis associated pregnancy complications. Ann Periodontol. 1998; 3(1): 233-250.
- Otenio CC, Fonseca I, Martins MF, Ribeiro LC, Assis NM, Ferreira AP, Ribeiro RA. Expression of IL-1beta, IL-6, TNF-alpha, and iNOS in pregnant women with periodontal disease. Genet Mol Res. 2012; 11(4): 4468-4478.
- Hill GB. Preterm birth: associations with genital and possibly oral microflora. Ann Periodontol. 1998; 3(1): 222-232.
- Xiong X, Buekens P, Vastardis S, Yu SM. Periodontal disease and pregnancy outcomes: state-of-the-science. Obstet Gynecol Surv. 2007; 62(9): 605-615.
- Roberts JM, Pearson G, Cutler J, Lindheimer M. Summary of the NHLBI Working Group on Research on Hypertension During Pregnancy. Hypertension. 2003; 41(3): 437-445.
- Lam C, Lim KH, Karumanchi SA. Circulating angiogenic factors in the pathogenesis and prediction of preeclampsia. Hypertension. 2005; 46(5): 1077-1085.
- Redman CW, Sargent IL. Latest advances in understanding preeclampsia. Science. 2005; 308(5728): 1592-1594.
- Pralhad S, Thomas B, Kushtagi P. Periodontal disease and pregnancy hypertension: a clinical correlation. J Periodontol. 2013; 84(8): 1118- 1125.
- Wei BJ, Chen YJ, Yu L, Wu B. Periodontal disease and risk of preeclampsia: a meta-analysis of observational studies. PLoS One. 2013; 8(8): e70901.
- Canakci V, Canakci CF, Canakci H, Canakci E, Cicek Y, Ingec M, Ozgoz M, Demir T, Dilsiz A, Yagiz H. Periodontal disease as a risk factor for pre-eclampsia: a case control study. Aust N Z J Obstet Gynaecol. 2004; 44(6): 568-573.
- Walker JJ. Pre-eclampsia. Lancet. 2000; 356(9237): 1260-1265.
- Roberts JM, Gammill HS. Preeclampsia: recent insights. Hypertension. 2005; 46(6): 1243-1249.
- Chavarria ME, Lara-Gonzalez L, Garcia-Paleta Y, Vital-Reyes VS, Reyes A. Adhesion molecules changes at 20 gestation weeks in pregnancies complicated by preeclampsia. Eur J Obstet Gynecol Reprod Biol. 2008; 137(2): 157-164.
- Van Nieuwenhoven AL, Moes H, Heineman MJ, Santema J, Faas MM. Cytokine production by monocytes, NK cells, and lymphocytes is different in preeclamptic patients as compared with normal pregnant women. Hypertens Pregnancy. 2008; 27(3): 207-224.
- Chaparro A, Sanz A, Quintero A, Inostroza C, Ramirez V, Carrion F, Figueroa F, Serra R, Illanes SE. Increased inflammatory biomarkers in early pregnancy is associated with the development of pre-eclampsia in patients with periodontitis: a case control study. J Periodontal Res. 2013; 48(3): 302-307.
- Canakci V, Canakci CF, Yildirim A, Ingec M, Eltas A, Erturk A. Periodontal disease increases the risk of severe pre-eclampsia among pregnant women. J Clin Periodontol. 2007; 34(8): 639-645.
- Xie Y, Xiong X, Elkind-Hirsch KE, Pridjian G, Maney P, Delarosa RL, Buekens P. Change of periodontal disease status during and after pregnancy. J Periodontol. 2013; 84(6): 725-731.
- Dasanayake AP, Chhun N, Tanner AC, Craig RG, Lee MJ, Moore AF, Norman RG. Periodontal pathogens and gestational diabetes mellitus. J Dent Res. 2008; 87(4): 328-333.
- Chokwiriyachit A, Dasanayake AP, Suwannarong W, Hormdee D, Sumanonta G, Prasertchareonsuk W, Wara-Aswapati N, Combellick J, Pitiphat W. Periodontitis and gestational diabetes mellitus in non- smoking females. J Periodontol. 201; 84(7): 857-862.
- Chanprapaph P, Sutjarit C. Prevalence of gestational diabetes mellitus (GDM) in women screened by glucose challenge test (GCT) at Maharaj Nakorn Chiang Mai Hospital. J Med Assoc Thai. 2004; 87(10): 1141-1146.
- Serirat S, Deerochanawong C, Sunthornthepvarakul T, Jinayon P. Gestational diabetes mellitus. J Med Assoc Thai. 1992; 75(6): 315-319.
- Habib FA. Evaluation of periodontal status among saudi females with gestational diabetes and its relation to glucose and lipid homeostasis in ohud hospital, Al madina Al-munwarrah. Int J Health Sci (Qassim). 2009; 3(2): 143-154.
- Xiong X, Buekens P, Goldenberg RL, Offenbacher S, Qian X. Optimal timing of periodontal disease treatment for prevention of adverse pregnancy outcomes: before or during pregnancy? Am J Obstet Gynecol. 2011; 205(2): 111 e1-6.
- Iams JD, Romero R, Culhane JF, Goldenberg RL. Primary, secondary, and tertiary interventions to reduce the morbidity and mortality of preterm birth. Lancet. 2008; 371(9607): 164-175.