Clinical implications of salivary periodontopathic bacteria in pregnant women

采用PCR-invader方法对80例妊娠10-13周和30-35周的孕妇唾液中牙龈卟啉单胞菌（Pg）、坦那氏菌（Tf）、中间普雷沃菌（Pi）和伴放线菌聚集菌（Aa）4种牙周致病菌进行了检测。然后，我们评估了与牙周病相关的口腔症状的关系，包括牙龈出血，牙龈肿胀，牙齿松动，口臭和口腔干燥。妊娠10-13周时Aa、Pi、Pg和Tf的检出率分别为18%、23%、20%和98%;妊娠30- 35周时Aa、Pi、Pg和Tf的检出率分别为8%、21%、24%和89%。在两个时期都检测到Pi的孕妇与在两个时期都没有检测到Pi的孕妇相比，牙龈出血（p<0.05）、牙龈肿胀（p<0.01）、牙齿松动（p<0.05）和口臭（p<0.05）的发生率显著更高。同样，在两个时期都检测到Pg的孕妇牙龈出血的发生率显著较高（p<0.05）。为了在怀孕期间保持口腔健康，当唾液检查中检测到Pi或Pg时，可能需要对女性进行更积极的干预。

We investigated salivary levels of 4 periodontopathic bacteria, Porphyromonas gingivalis ( Pg), Tannerella forsythensis ( Tf), Prevotella intermedia ( Pi) and Aggregatibacter actinomycetemcomitans ( Aa), in 80 pregnant women at 10-13 weeks and 30-35 weeks of pregnancy by PCR-invader analysis. We then evaluated the relationships with oral symptoms related to periodontal diseases, including gingival bleeding, swollen gums, loose teeth, bad breath and oral dryness. Detection rates of Aa, Pi, Pg and Tf among the women were 18, 23, 20 and 98%, respectively, at 10-13 weeks of pregnancy, and 8, 21, 24 and 89%, respectively, at 30-35weeks of pregnancy, showing no significant differences between the two periods. Pregnant women in whom Pi was detected during both periods had a significantly higher incidence of gingival bleeding (p<0.05), swollen gums (p<0.01), loose teeth (p<0.05) and bad breath (p<0.05) as compared to pregnant women in whom Pi was not detected during both periods. Similarly, pregnant women in whom Pg was detected during both periods had a significantly higher incidence of gingival bleeding (p<0.05). To maintain oral health during pregnancy, more aggressive intervention may be necessary for women when Pi or Pg is detected on salivary examination.