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Periapical infection may affect birth outcomes via systemic inflammation

Harjunmaa, U; Doyle, R; Järnstedt, J; Kamiza, S; Jorgensen, JM; Stewart, CP; Shaw, L; ... Ashorn, P; + view all (2018) Periapical infection may affect birth outcomes via systemic inflammation. Oral Diseases , 24 (5) pp. 847-855. 10.1111/odi.12817. Green open access

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Abstract

OBJECTIVES: Maternal dental periapical infections are associated with preterm birth and intrauterine growth restriction. This study investigates if the association is mediated through bacterial spread from periapical lesions to placenta (direct pathway) or systemic inflammatory reaction (indirect pathway). MATERIALS AND METHODS: We compared birth outcomes in Malawian mothers with and without periapical infection. As markers of a direct pathway, we identified placental bacteria using a 16S rDNA approach, and assessed histological evidence of inflammation in the placenta and amniotic membranes. We measured C-reactive protein, alpha-1-acid glycoprotein and salivary cortisol as markers of an indirect pathway. We used regression models to associate the predictor variables with duration of pregnancy and newborn size. RESULTS: Of 1024 women, 23.5% had periapical infection. There was no association of periapical infection with either bacterial DNA or histological inflammation in placenta or membranes. Periapical infection was associated with C-reactive protein, alpha-1-acid glycoprotein and cortisol concentrations in a dose-dependent manner at 36wk. Addition of alpha-1-acid glycoprotein or cortisol concentration into regression models attenuated the association between periapical infection and pregnancy outcomes. CONCLUSION: There was no evidence of direct spread of periapical bacteria to the placenta. Periapical infections and adverse pregnancy outcomes is in part mediated through systemic inflammation. This article is protected by copyright. All rights reserved.

Type: Article
Title: Periapical infection may affect birth outcomes via systemic inflammation
Location: Denmark
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/odi.12817
Publisher version: https://doi.org/10.1111/odi.12817
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Apical infection, birth size, duration of pregnancy, placental infection, systemic inflammation
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > Div of Biosciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10040579
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