The Potential Role of Maternal Periodontitis on Preterm Birth and Adverse Neonatal Neurologic Outcomes

Abstract

Periodontitis is an often overlooked but important risk factor for both preterm birth and adverse neonatal outcomes. With preterm birth being the leading cause of mortality for all children under the age of 5, any potentially modifiable risk factor associated with preterm birth must be fully evaluated. Periodontal disease is due to bacterial infection of the gingivae with resulting localized and systemic inflammation that can have profound effects in both nonpregnant and pregnant individuals. In pregnancy, several studies have demonstrated an association between periodontitis and preterm birth. Furthermore, extensive evidence demonstrates that fetal exposure to systemic inflammation during gestation predisposes to brain injury and neurodevelopmental delay. Thus, periodontitis and the resulting inflammatory cascade not only affect the pregnant individual but also have significant lifelong consequences on the development and well-being of future offspring. In this review, we will first discuss the epidemiology, prevalence, and pathophysiology of periodontitis. We will then explore the medical literature evaluating the association between periodontitis and preterm birth prior to delving into the potential for neurodevelopmental delay and brain injury among offspring. Finally, we will conclude by discussing future directions and unanswered questions related to periodontitis and its relationship with preterm birth and adverse neonatal outcomes. demonstrated prevention of preterm birth, LBW, or fetal growth restriction with dental scaling and root planing of the mother in the second trimester. 77,78 Other findings have similarly not found improvements in birth outcomes related to periodontal treatment during gestation. 79 These results suggest that traditional methodologies for treating maternal periodontal disease during the second trimester of pregnancy do not likely have significant effects in the prevention of adverse offspring outcomes.