Periodontitis and gestational diabetes

Background + Aims

• Gestational diabetes mellitus (GDM) and periodontal inflammation are independently associated with adverse pregnancy outcomes, including preterm birth, preeclampsia, and low birth weight.
• Gingivitis, a bacterial-induced periodontal condition common during pregnancy, has been linked to systemic inflammation and poor outcomes. Specific periodontal pathogens, such as Porphyromonas gingivalis and Treponema denticola, are associated with maternal and foetal complications.
• This study aimed to explore the interplay between GDM, gingivitis, and oral infections with key pathogens, focusing on their collective impact on systemic inflammatory burden, measured via C-reactive protein (CRP).

Materials + Methods

• This case-control study recruited 117 pregnant women in their third trimester and categorised them into four groups:
  • No GDM or gingivitis
  • Gingivitis only
  • GDM only
  • Both GDM and gingivitis
• Diagnosis of GDM followed American Diabetes Association criteria, while gingivitis was identified based on clinical parameters like bleeding on probing (BOP) and probing depth (PD).
• PCR detected the presence of three periodontal pathogens:
  • P. gingivalis
  • T. denticola
  • Filifactor alocis
• CRP levels were quantified to measure systemic inflammation.
• Statistical analyses adjusted for confounders like age, BMI, and smoking status

Results

• Women with GDM or gingivitis had significantly higher incidence of all three pathogens compared to controls.
• Incidence rates were highest in women with both conditions.
• Gingivitis significantly increased CRP levels, regardless of GDM status.
• CRP levels were highest in women with both gingivitis and GDM.
• Gingivitis and GDM acted synergistically, exacerbating oral infections and inflammatory markers.

Limitations