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Gum disease may lead to premature delivery

Pregnant women suffering from serious gum disease are at a high risk of delivering prematurely.

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Pregnant women suffering from serious gum disease are at a high risk of delivering prematurely.Gum disease is caused by the bacterium that settles down in the plaque that forms on teeth. It can range from mild inflammation and occasional bleeding of gingivitis to a more serious stage where the gums pull away from the teeth, resulting in the decay of bones and other supporting structures of the teeth, potentially leading to tooth loss.Researchers from the University of Alabama at Birmingham, UK, analysed 139 pregnant women and found that those with severe gum disease were three times more likely to have a premature delivery than other women.Previous studies have linked severe gum disease to pre-term birth, as well as low birth weight, fetal growth restriction and certain other pregnancy complications. Similarly, other research has tied gum disease to the risk of heart attack and stroke. The explanation for all of these complications depends on the movement of gum disease bacteria. If these bugs enter the blood circulation, they may trigger damaging inflammation elsewhere in the body including the placenta.The researchers studied 59 women who entered spontaneous labour before the 32nd week of pregnancy, 44 who went full-term, and 36 who had labour induced early due to complications. All of the women had a dental exam within a few days of giving birth, the researchers analysed the placenta and umbilical cord blood for bacteria and certain markers of inflammation. They found that 49 per cent of the women who went into spontaneous pre-term labour had severe gum disease, compared with 25 per cent to 30 per cent of other women.In the current study, however, researchers found no association between gum disease and markers of inflammation in the upper genital tract at the time of delivery. This casts some doubt on the theory that gum disease bacteria spreads to the placenta to trigger early labour.When the researchers considered other factors, such as age, race, education and smoking, they found that severe gum disease was still linked to a roughly three-fold greater risk of premature delivery.It's possible that gum disease does not actually spur pre-term labour, instead, the two may be linked by some third unknown, factor. More clinical trials are required to see whether treating gum disease lowers the risk of pre-term delivery.
Obstetrics & Gynecology,
October 2004

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