Serum inflammatory mediators in pregnancy: changes after periodontal treatment and association with pregnancy outcomes.
Serum inflammatory mediators in pregnancy: changes after periodontal treatment and association with pregnancy outcomes.
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DOI：
10.1902/jop.2009.090236
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发表时间：
2009-11
影响因子：
4.3
通讯作者：
Ebersole JL
中科院分区：
文献类型：
--
作者：
Michalowicz BS;Novak MJ;Hodges JS;DiAngelis A;Buchanan W;Papapanou PN;Mitchell DA;Ferguson JE;Lupo V;Bofill J;Matseoane S;Steffen M;Ebersole JL
确定：1）妊娠21周前的孕妇牙周治疗是否改变了血清中炎症介质的水平; 2）这些介质的变化是否与出生结局相关。对823例妊娠期牙周炎患者在妊娠21周前或分娩后随机分为两组，分别进行洁治和根面平整术。分析了妊娠13周至16周6天（研究基线）和29-32周之间采集的血清中的C-反应蛋白、前列腺素E2、基质金属蛋白酶-9、纤维蛋白原、内毒素、白细胞介素（IL）-1β、IL-6、IL-8和肿瘤坏死因子-α。采用考克斯回归、多元线性回归、t检验、卡方和Fisher精确检验来检查生物标志物、牙周治疗、分娩时胎龄和出生体重之间的关联。796名女性有基线血清数据; 620名有基线和随访血清和出生数据。Periodamine治疗没有显著改变任何生物标志物的水平（P>0.05）。任何生物标志物的基线水平或较基线的变化与早产或婴儿出生体重均无显著相关性（P>0.05）。治疗组内毒素变化与探诊深度变化呈负相关（P<0.05）。在妊娠21周前分娩的孕妇中，非手术机械牙周治疗并没有减少全身（血清）炎症标志物。在牙周炎孕妇中，这些标记物在妊娠13-17周和29-32周的水平与早产风险或婴儿出生体重无关。
To determine: 1) if periodontal treatment in pregnant women before 21 weeks of gestation alters levels of inflammatory mediators in serum; and 2) if changes in these mediators are associated with birth outcomes. 823 pregnant women with periodontitis were randomly assigned to receive scaling and root planing before 21 weeks of gestation or after delivery. Serum obtained between 13 weeks and 16 weeks 6 days (study baseline) and 29–32 weeks gestation was analyzed for C-reactive protein, prostaglandin E2, matrix metalloproteinase-9, fibrinogen, endotoxin, interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor-α. Cox regression, multiple linear regression, t-tests, chi-square and Fisher’s exact tests were used to examine associations between the biomarkers, periodontal treatment, and gestational age at delivery and birthweight. 796 women had baseline serum data; 620 had baseline and follow-up serum and birth data. Periodontal treatment did not significantly alter the level of any biomarker (P>0.05). Neither baseline levels nor change from baseline in any biomarker was significantly associated with preterm birth or infant birthweight (P>0.05). In treatment subjects, change in endotoxin was negatively associated with change in probing depth (P<0.05). Non-surgical mechanical periodontal treatment in pregnant women delivered before 21 weeks of gestation did not reduce systemic (serum) markers of inflammation. In pregnant women with periodontitis, levels of these markers at 13–17 weeks and 29–32 weeks gestation were not associated with risk for preterm birth or with infant birthweight.
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