Preterm birth and/or low birth weight are associated with periodontal disease and the increased placental immunohistochemical expression of inflammatory markers
Elena Pozo1, Francisco Mesa2, Mohamed H. Ikram1, Alberto Puertas3, Laura Torrecillas-Martínez4, Inmaculada Ortega-Oller4, Antonio Magán-Fernández2, María Dolores Rodríguez-Martínez6, Miguel Padial-Molina4,5, Elena Sánchez-Fernández4, Pablo Galindo-Moreno4 and Francisco O’Valle6
1Private practice in periodontics, Granada, Spain, 2Periodontology Department, School of Dentistry, University of Granada, Spain, 3Department of Obstetrics and Gynecology, Virgen de las Nieves University Hospital, Granada, Spain, 4Oral Surgery Department, School of Dentistry, University of Granada, Spain, 5Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA and 6Pathology Department, School of Medicine IBIMER, CIBM, University of Granada, Granada, Spain
Offprint requests to: Prof. Francisco O’Valle, School of Medicine, University of Granada, Avda. de Madrid s/n., 18071, Granada, Spain. e-mail: fovalle@ugr.es
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Summary. The objective of this study was to determine whether gynecological and periodontal clinical parameters and the immunohistochemical expression in placental chorionic villi of the markers cyclooxygenase-2 (COX-2), interleukin (IL)-1β, vascular endothelial growth factor receptor 1 (VEGFR1), podoplanin, and Heat Shock Protein (HSP70) are associated with preterm birth (PB) and/or low birth weight (LBW) neonates.
Material and methods: An observational case-control study was performed in 130 puerperal women: mothers of PB/LBW neonates (cases, n=65) and mothers of full-term normal-weight neonates (controls, n=65). Data were gathered from all participants on socio-demographic, gynecological, and periodontal variables and on placental immunohistochemical COX-2, IL-1β, VEGFR1, podoplanin, and HSP70 expression.
Results: Among the 42 women with mild/moderate periodontitis or gingivitis, the studied periodontal variables were significantly worse and the placental COX-2 (p=0.043), HSP70 (p=0.001), IL-1β (p=0.001), VEGFR1 (p=0.032), and podoplanin (p=0.058) expressions were significantly higher in the cases than in the controls. In comparison to the mothers without periodontitis, only COX-2 (p=0.026) and VEGFR1 (p=0.005) expressions were significantly increased in those with the disease. Increased COX-2 values were detected in the women with a history of genitourinary infection (p=0.036), premature rupture of membrane (p=0.012), or drug treatment (p=0.050).
Conclusions: The etiology of preterm birth and/or low birth weight is multifactorial and involves consumption habits, social-health factors, and infectious episodes. These adverse pregnancy outcomes were associated with periodontitis and the increased placental expression of IL-1β, COX-2, VEGFR1, and HSP70. Histol Histopathol 31, 231-237 (2016)
Key words: Cyclooxygenase 2, Immunohistochemistry, Placenta, Chronic periodontitis, Gingivitis
DOI: 10.14670/HH-11-671