Associations Between Periodontal and Periapical Inflammation and Pregnancy Outcomes

A. Specific Aims

1. To determine possible associations between periapical oral infection and adverse pregnancy outcomes in female patients in the School of Dentistry, the Dental/Dental Emergent Care Clinic (Jackson Medical Mall), and the UMC Hospital.
2. To examine the effects of several confounding variables related to stress from pain from the periapical infections on these adverse outcomes.

B. Background and Significance

During the past five years there has been increasing evidence for associations between periodontal infection and adverse pregnancy outcomes in humans, including preterm birth, low birth-weight babies, gestational diabetes, miscarriage, and preeclampsia. These events likely result from oral infections because bacteremia and release of pro-inflammatory cytokines from the diseased oral sites have been described.

Proinflammatory cytokines have been reported to be harmful and destructive to a successful pregnancy. The adverse fetal inflammatory response to TNF-alpha, IL-6 and C-reactive protein has been associated with preterm birth. These cytokines are also commonly associated with oral infections, both periodontal and periapical11. In addition, oral infections often produce pain and stress, which are considered harmful to a successful pregnancy. Since the effects of periodontal infections on adverse pregnancy outcomes have been described, it would be worthwhile to examine the specific effects of oral periapical abscesses on adverse birth outcomes, to begin to determine whether there is an association between this type of oral infection and these adverse outcomes.