Gum Disease in Pregnancy

Gum Disease in Pregnancy Linked to Premature Low-Weight Babies
By Jane E. Brody
Published: October 9, 1996

Although it may seem improbable, infection in the gums of a pregnant woman may lead to a more than sevenfold increase in her risk of delivering a premature baby of low birth weight, according to findings published yesterday in The Journal of Periodontology. The study suggests that untreated periodontal disease may account for a large share of premature births for which no other explanation can be found. The research team of periodontists, obstetrician-gynecologists and epidemiologists emphasized that their findings, based on a detailed analysis of 124 births, were preliminary and needed to be confirmed by “larger prospective multicenter investigations.” Nonetheless, they estimated from their findings that periodontal infection might be responsible for as many as 18 percent of the 250,000 premature babies that are born weighing less than 5.5 pounds in the United States each year.If such births could be prevented by proper periodontal care and treatment of periodontal disease in women of childbearing age, the researchers said, premature births might be reduced by about 45,500 each year at a savings of almost $1 billion in intensive neonatal care.

Dr. Steven Offenbacher, the lead author of the new report, said in an interview:

“A prenatal visit to a periodontist is a reasonable thing to do at this point. Any infection in a pregnant women should be a concern. When you have periodontal disease, even eating an apple or brushing your teeth can release bacteria and their toxins into the bloodstream.”

An unpublished study conducted a decade ago at Harvard Universityʼs Forsyth Dental Clinic found a similar relationship between periodontal disease and preterm births, said Dr. James McGregor, a professor of obstetrics and gynecology at the University of Colorado in Denver.“This new study is just fascinating,” Dr. McGregor said. “It goes along with the findings that other infections — urinary tract infections and pneumonia, for example — increase the risk for preterm birth. And we have shown that you can decrease preterm births by 50 percent if you treat common reproductive tract infections like bacterial vaginosis and chlamydia.”

In the newly published report, Dr. Offenbacher and his colleagues at the University of North Carolina and Meharry Medical College in Nashville explained how an infection in the mouth might interfere with the development of an sunborn child and lead to premature labor. They noted that other kinds of bacterial infections in pregnant women that had been linked to premature births did not necessarily involve infections of the fetus or placenta.

Rather than directly attacking the fetus, the bacteria appear to retard fetal growth by releasing toxins into the womanʼs bloodstream that reach the placenta and interfere with fetal development. In addition, the infection stimulates the womanʼs body to produce inflammatory chemicals, similar to those used to induce abortion, that can cause the cervix to dilate and set off uterine contractions.

   Read the full article at NYTimes.

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