Preconception periodontitis and adverse pregnancy outcomes in a prospective cohort of pregnancy planners

妊娠计划者前瞻性队列中的孕前牙周炎和不良妊娠结局

• 批准号: 10727141
• 负责人: Brenda Heaton
• 金额: $ 15.4万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10727141
• 关键词: Address; Adult; Affect; Age; Age Years; American; Attention; Birth; Chronic; Clinic; Clinical; Cohort Studies; Conceptions; Coupled; Data; Development; Diagnosis; Disease; Early Diagnosis; Eclampsia; Enrollment; Epidemiologic Methods; Etiology; Foundations; Future; Gestational Diabetes; Goals; Health; Health Status; Hypertension; Immune response; Incidence; Infection; Inflammation; Inflammatory; Internet; Intervention; Intervention Studies; Left; Low Birth Weight Infant; Maternal Mortality; Measurement; Mediation; Metabolic Diseases; Methods; Modernization; Nature; Neonatal Mortality; Oral health; Outcome; Participant; Pathway interactions; Patient Self-Report; Periodontal Diseases; Periodontitis; Play; Population; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Premature Birth; Prevalence; Prevention; Probability; Prospective cohort; Questionnaires; Randomized; Reporting; Reproductive Health; Research; Risk; Risk Factors; Role; Science; Selection Bias; Source; Therapeutic Intervention; Time; Tooth structure; United States; Woman; Work; adverse birth outcomes; adverse pregnancy outcome; aged; bone; cohort; improved; insight; maternal morbidity; maternal outcome; mortality; neonatal morbidity; neonatal outcome; oral tissue; pregnancy disorder; pregnancy hypertension; pregnant; prospective; reproductive; reproductive outcome; severe maternal morbidity; stem; success; systemic inflammatory response; treatment trial

The prevalence of hypertensive disorders (e.g. gestational hypertension, pre-eclampsia, and eclampsia) and metabolic disorders (e.g. Gestational Diabetes Mellitus) is high and significantly contribute to maternal morbidity and mortality. Further, these conditions are primary risk factors for preterm birth and low-birthweight outcomes, and thus also contribute dramatically to neonatal morbidity and mortality. Given the increasing rates of these disorders in recent years, and the associated detrimental health outcomes, prevention and early detection are critical for improving maternal and neonatal outcomes. Systemic inflammation prior to pregnancy is regarded as a contributing factor in the development of these conditions and outcomes, yet the underlying causes are mostly unknown. Understanding and addressing sources of systemic inflammation in the preconception period may hinder the development of hypertensive and metabolic disorders during pregnancy, as well as reduce the incidence of preterm birth and low birthweight outcomes. Periodontitis is the most common chronic inflammatory condition among U.S adults, affecting 38% of women aged 30 years and older. The associations between periodontitis and pregnancy-related conditions and outcomes have been studied in recent decades. However, results of this work have been mixed, owing to the restricted measurement of periodontitis during pregnancy, the lack of data on important confounders, and difficulty in obtaining enough data to provide meaningful, precise results. Through the use of prospective data obtained from PREgnancy STudy Online (PRESTO), an ongoing internet-based preconception cohort study of nearly 17,000 North American women planning a pregnancy, this proposal aims to: 1. Estimate the associations between preconception periodontitis and hypertensive and metabolic disorders in pregnancy, preterm birth, and low birthweight outcomes. 2. Evaluate the validity of the associations through the conduct of probabilistic quantitative bias analyses and the incorporation of inverse probability weighting to explore the plausibility of alternative explanations for the observed results (e.g., unmeasured confounding, exposure misclassification bias, and selection bias). Completion of the proposed aims will enhance our understanding of the role that periodontitis may play in maternal and neonatal morbidity and mortality and may provide a foundation for mechanistic studies that elucidate inflammatory pathways underlying these associations. Eventually, this work could lead to therapeutic interventions to reduce the population-level burden of these serious reproductive health conditions and outcomes.

高血压疾病的患病率（例如妊娠高血压，前宾夕法尼亚和eclampsia）和 代谢性疾病（例如妊娠糖尿病）很高，并显着有助于母亲 发病率和死亡率。此外，这些条件是早产和低次量的主要危险因素 结果，因此也有助于新生儿的发病率和死亡率。考虑到率增加 近年来这些疾病以及相关的有害健康结果，预防和早期 检测对于改善孕产妇和新生儿结局至关重要。怀孕前的系统性炎症 被认为是这些条件和结果的发展的一个促成因素，但基础 原因大多是未知的。理解和解决系统性炎症的来源 先男见面时期可能会阻碍怀孕期间高血压和代谢障碍的发展 以及减少早产和低出生体重结局的发生率。牙周炎是最大的 美国成年人中常见的慢性炎症状况，影响38％的30岁及以上的女性。 在 最近几十年。但是，由于测量的限制，这项工作的结果混合了 怀孕期间牙周炎，缺乏有关重要混杂因素的数据，并且难以获得足够的难度 提供有意义，精确的结果的数据。通过使用从怀孕获得的前瞻性数据 在线研究（PRESTO），这是一项持续的基于互联网的见面群体研究，近17,000个北 计划怀孕的美国妇女，该提议的目的是： 1。估计牙周炎和高血压和代谢性疾病之间的关联 怀孕，早产和低出生体重结局。 2。通过进行概率定量偏差分析和 纳入反合概率加权以探索替代解释的合理性 观察到的结果（例如，未衡量的混杂，暴露误差偏见和选择偏见）。 拟议目标的完成将增强我们对牙周炎可能在 孕产妇和新生儿的发病率和死亡率，并可能为机械研究提供基础 阐明这些关联的基础炎症途径。最终，这项工作可能导致治疗性 减轻这些严重生殖健康状况的人口级负担的干预措施和 结果。