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Periodontal disease in pregnant women and its consequences for the newborn

Grant number: 15/23304-0
Support Opportunities:Scholarships in Brazil - Scientific Initiation
Effective date (Start): March 01, 2016
Effective date (End): August 31, 2017
Field of knowledge:Health Sciences - Medicine - Maternal and Child Health
Principal Investigator:Cátia Regina Branco da Fonseca
Grantee:Marina Guim Otsuka Padovan Figueiredo
Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil


Periodontal diseases affect the support tissue (gingival), as well as the sustentation tissue (cementum, periodontal ligament and bone).They are induced by the alteration of the oral microflora, leading to the activation of the immune and inflammatory response.The hormones estrogen and progesterone have receptors on gingival tissue. According to Cunha (2011), during pregnancy, women are exposed to high levels of steroid hormones produced by the placenta.These hormones accumulate in the tissue and gingival fluid, constituting important growth factors of harmful bacteria to the oral health of the woman.In periodontal disease, these microorganisms responsible for stimulating the immunoinflammatory response lead to the increased of cytokine and pharmacologically active mediators - among which it is possible to highlight interleukin 1-beta, IL-6, tumor necrosis factor - alpha and prostaglandin E2 (Cunha, 2011).It is known that cytokines, as well as the infectious agents, can spread systemically through the bloodstream, since they do not remain stocked in the gingival tissue. This spread suggests an association between the disease and the increased of the risk of systemic changes (Passini Junior, et al. 2007),including premature labor for pregnant women (which may result in the birth of a low weight newborn). Some inconclusive studies have already essayed to establish the link between periodontal disease and the increase of the risk of gestational diseases; such as preeclampsia.Given this scenario, it is proposed an analogy between the periodontal disease and the pregnancy complications, during labor, preeclampsia and low birth weight.The objective is to study the correlation between the presence of periodontal disease and / or presence of caries during pregnancy and birth conditions of the newborn, in Botucatu (SP), pregnant women and births in the period 2012-2014.Methods:Based on the diagnosis of an oral disease conducted on 142 pregnant women from Botucatu - a sampling distribution from all of the Health Units - this method aims to raise secondary data from the medical records of the Botucatu Clinics Hospital, as well as the Live Births Declaration, through The System of Information on Live Births (SINASC, the Portuguese language acronym), in order to obtain data from the birth of the newborn children.A database will be built using Microsoft Office Excel 2007 (Washington, USA), and will be analyzed by the Statistical Analysis System (SAS, North Carolina, USA), version 9.2.The chi-square test will be used to evaluate the association among variables. The significance level considered will be 5% (alpha = 0.05) for rejection of the null hypothesis.In the multivariable analysis, a logistic regression model was used to investigate periodontal disease as a dependent variable in relation to other variables of interest. For multivariable analyses, p-value, calculated by Wald test, will be considered significant for p d 0.05. To determine the effect of periodontal disease and each variable, odds ratios with 95% confidence intervals will be calculated using the logistic regression model with k explanatory variables [36]. Results are presented in tables and graphs.The project was sent for evaluation and approval of the Comitê de Ética em Pesquisa (Committee of Ethics in Research) and approved in September/2015, thus the survey of numbers of medical records of pregnant women and their newborns for subsequent collection of data records started in October 2015.It is expected to obtain data that may relate (or not) the periodontal diseases to the newborns birth conditions.

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
OTSUKA PADOVAN FIGUEIREDO, MARINA GUIM; TAKITA, STEFANIE YAEMI; RAMOS DOURADOL, BIANCA MARIA; MENDES, HELDERJAN DE SOUZA; TERAKADO, ERICK OLSEN; DE CARVALHO NUNES, HELIO RUBENS; BRANCO DA FONSECA, CATIA REGINA. Periodontal disease: Repercussions in pregnant woman and newborn health-A cohort study. PLoS One, v. 14, n. 11, . (15/23313-0, 13/12053-1, 15/23304-0)

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