بررسی ارتباط بیماریهای پریودنتال و خطر بروز پره‌اکلامپسی در زنان باردار

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استاد گروه زنان و مامایی، واحد توسعه تحقیقات بالینی بیمارستان امام رضا (ع)، دانشکده پزشکی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران.

2 استادیار گروه بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران.

3 استادیار گروه دندان‌پزشکی، دانشکده دندان‌پزشکی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران.

4 دستیار تخصصی زنان و مامایی، واحد توسعه تحقیقات بالینی بیمارستان امام رضا (ع)، دانشکده پزشکی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران.

5 کارشناس ارشد آمار، واحد توسعه تحقیقات بالینی بیمارستان امام رضا (ع)، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران.

6 کارشناس ارشد مشاوره در مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران.

7 استاد گروه آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران

چکیده

مقدمه: از آنجا‌ که بیماری پریودنتال با التهاب مزمن همراه است، لذا می‌‌شود فرض کرد بیماران مبتلا به بیماری پریودنتال ریسک بالاتری برای ابتلاء به پره‌اکلامپسی دارند، بنابراین مطالعه حاضر با هدف تعیین ارتباط بیماری‌های پریودنتال و خطر بروز پره‌اکلامپسی در زنان باردار انجام شد.
روش‌کار: این مطالعه مورد- شاهدی در سال 98-1396 بر روی 100 نفر از زنان باردار مراجعه‌کننده به بیمارستان امام رضا (ع) کرمانشاه در دو گروه مورد (مادران پره‌اکلامپسی) و گروه شاهد (بارداری نرمال) انجام شد. پرسشنامه‌ای بر ‌اساس اطلاعات مورد نیاز شامل اطلاعات دموگرافیک، پارامترهای پریودنتال شامل: خونریزی هنگام پروب کردن، پلاک ایندکس، سطح چسبندگی کلینیکی، عمق پاکت برای هر بیمار تکمیل شد و سپس اطلاعات با استفاده از نرم‌افزار آماری SPSS (نسخه 20) و آزمون‌های تی دانشجویی و یومن‌ویتنی مورد تجزیه و تحلیل آماری قرار گرفت. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: در بررسی شاخص‌های پریودنتال، بین دو گروه مورد مطالعه از نظر شاخص خونریزی در پروب (329/0=p)، شاخص عمق پاکت پروب (05/0<p) و شاخص سطح چسبندگی کلینیکی (733/0=p) اختلاف آماری معناداری وجود نداشت و تنها شاخص پلاک در مادران پره‌اکلامپسی به‌طور معناداری پایین‌تر از مادران با بارداری نرمال بود (007/0=p).
نتیجه‌گیری: با وجود این‌که رابطه معنی‌داری بین پره‌اکلامپسی و پارامترهای بیماری پریودنتال مادر مشاهده نشد، اما پیشنهاد می‌گردد که غربالگری و پیشگیری از بیماری پریودنتال در مراقبت‌های پیش از بارداری به‌منظور بهبود بهداشت دهان و دندان مادران و هم بهبود نتایج بارداری از طریق همکاری‌های بین حرفه‌ای مورد توجه قرار گیرد.

کلیدواژه‌ها


عنوان مقاله [English]

The relationship between periodontal diseases and the risk of preeclampsia in pregnant women

نویسندگان [English]

  • Negin Rezavand 1
  • Mastaneh Kamravamanesh 2
  • Masoumeh Eyvazi 3
  • Jila Manouchehri 4
  • Maryam Hemati 5
  • Rozhin Feali 6
  • Mansour Rezaei 7
1 Professor, Department of Obstetrics and Gynecology, Clinical Research Development Center of Imam Reza Hospital, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
2 Assistant Professor, Department of Reproductive Health, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
3 Assistant Professor, Department of Periodontology, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran.
4 Resident, Department of Obstetrics and Gynecology, Clinical Research Development Center of Imam Reza Hospital, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
5 M.Sc. of Statistics, Clinical Research Development Center of Imam Reza Hospital, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
6 M.Sc. of Midwifery Counseling, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
7 Professor, Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
چکیده [English]

Introduction: Since periodontal disease is associated with chronic inflammation, it can be assumed that patients with periodontal disease have a higher risk of developing preeclampsia. Therefore, this study was performed with aim to determine the relationship between periodontal diseases and the risk of preeclampsia in pregnant women.
 Methods: This case-control study was conducted in 2017-2019 on 100 pregnant women referred to Kermanshah Imam Reza Hospital in two groups of case (preeclamptic women) and control (normal pregnancy). The questionnaire was completed for each patient based on the required information including demographic information, periodontal parameters including bleeding on probing, plaque index, clinical attachment level, probing pocket depth. Data were analyzed using SPSS statistical software (version 20) and Mann–Whitney U and Student's t-tests. P<0.05 was considered statistically significant.
Results: The study of periodontal indicators showed that there was no significant difference between the two groups in terms of bleeding on probing (P = 0.329), probing pocket depth index (P> 0.05) and clinical attachment level (P = 0.733). Only the plaque index was significantly lower in mothers with preeclampsia than mothers with normal pregnancies (P = 0.007).
 Conclusion: Although no significant relationship was found between preeclampsia and maternal periodontal disease parameters, however, it is recommended that screening and prevention of periodontal disease in prenatal care be considered in order to improve maternal oral health and improve pregnancy outcomes through inter-professional collaboration.

کلیدواژه‌ها [English]

  • periodontal disease
  • Preeclampsia
  • pregnancy
  1. Desai K, Desai P, Duseja S, Kumar S, Mahendra J, Duseja S. Significance of maternal periodontal health in preeclampsia. Journal of International Society of Preventive & Community Dentistry 2015; 5(2):103-107.
  2. Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, et al. Williams Obstetrics. 25nd ed. New York: McGraw-Hill; 2018.
  3. James DK, Steer PJ, Weiner CP, Gonik B. High risk pregnancy e-book: Management options-expert consult. Elsevier Health Sciences; 2010.
  4. Park Y, Cho GJ, Kim LY, Lee TS, Oh MJ, Kim YH. Preeclampsia increases the incidence of postpartum cerebrovascular disease in Korean population. Journal of Korean medical science 2018; 33(6).
  5. Steegers EA, Von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. The Lancet 2010; 376(9741):631-44.
  6. Shiadeh MN, Moghadam ZB, Adam I, Saber V, Bagheri M, Rostami A. Human infectious diseases and risk of preeclampsia: an updated review of the literature. Infection 2017; 45(5):589-600.
  7. Offenbacher S. Periodontal diseases: pathogenesis. Annals of periodontology 1996; 1(1):821-78.
  8. Shah SB, Shah N, Mehta R. Evaluation of relationship between maternal periodontal status and preeclampsia: A case-control study. Int J Res Med 2015; 4(2):66-72.
  9. Raitapuro-Murray T, Molleson TI, Hughes FJ. The prevalence of periodontal disease in a Romano-British population c. 200-400 AD. British dental journal 2014; 217(8):459-66.
  10. Ghanbari H, Foruzanfar A, Hafizi Lotfabadi L, Mokhtari MR, Ghaemi D, Farazi F, et al. The effect of periodontal disease on preterm fetal abortions in pregnant women with periodontitis. Iran J Obstet Gynecol Infertil 2014; 17(108):1-8.
  11. Krüger MS, Casarin RP, Pinto GD, Pappen FG, Camargo MB, Correa FO, et al. Maternal periodontal disease and adverse perinatal outcomes: is there an association? A hospital-based case-control study. The Journal of Maternal-Fetal & Neonatal Medicine 2019; 32(20):3401-7.
  12. Xiong X, Buekens P, Fraser WD, Beck J, Offenbacher S. Periodontal disease and adverse pregnancy outcomes: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology 2006; 113(2):135-43.
  13. Kinane DF. Causation and pathogenesis of periodontal disease. Periodontology 2000 2001; 25(1):8-20.
  14. Vanterpool SF, Tomsin K, Reyes L, Zimmermann LJ, Kramer BW, Been JV. Risk of adverse pregnancy outcomes in women with periodontal disease and the effectiveness of interventions in decreasing this risk: protocol for systematic overview of systematic reviews. Systematic reviews 2016; 5(1):1-6.
  15. Gesase N, Miranda-Rius J, Brunet-Llobet L, Lahor-Soler E, Mahande MJ, Masenga G. The association between periodontal disease and adverse pregnancy outcomes in Northern Tanzania: a cross-sectional study. African health sciences 2018; 18(3):601-11.
  16. Karnik AA, Pagare SS, Krishnamurthy V, Vahanwala SP, Waghmare M. Determination of salivary flow rate, pH, and dental caries during pregnancy: A study. Journal of Indian Academy of Oral Medicine and Radiology 2015; 27(3):372-6.
  17. Jiang H, Su Y, Xiong X, Harville E, Wu H, Jiang Z, et al. Prevalence and risk factors of periodontal disease among pre-conception Chinese women. Reproductive health 2016; 13(1):1-8.
  18. Piscoya MD, Ximenes RA, Silva GM, Jamelli SR, Coutinho SB. Periodontitis-associated risk factors in pregnant women. Clinics 2012; 67(1):27-33.
  19. Ifesanya JU, Ifesanya AO, Asuzu MC, Oke GA. Determinants of good oral hygiene among pregnant women in ibadan, South-Western Nigeria. Annals of Ibadan Postgraduate Medicine 2010; 8(2):95-100.
  20. Iheozor‐Ejiofor Z, Middleton P, Esposito M, Glenny AM. Treating periodontal disease for preventing adverse birth outcomes in pregnant women. Cochrane Database of Systematic Reviews 2017(6).
  21. Komine‐Aizawa S, Aizawa S, Hayakawa S. Periodontal diseases and adverse pregnancy outcomes. Journal of Obstetrics and Gynaecology Research 2019; 45(1):5-12.
  22. Parihar AS, Katoch V, Rajguru SA, Rajpoot N, Singh P, Wakhle S. Periodontal disease: a possible risk-factor for adverse pregnancy outcome. Journal of international oral health: JIOH 2015; 7(7):137-42.
  23. Siqueira FM, Cota LO, Costa JE, Haddad JP, Lana ÂM, Costa FO. Maternal periodontitis as a potential risk variable for preeclampsia: A case‐control study. Journal of periodontology 2008; 79(2):207-15.
  24. Kunnen A, Blaauw J, Van Doormaal JJ, Van Pampus MG, Van Der Schans CP, Aarnoudse JG, et al. Women with a recent history of early‐onset pre‐eclampsia have a worse periodontal condition. Journal of clinical periodontology 2007; 34(3):202-7.
  25. Haruzivishe C. Determinants of Periodontal Disease in Pregnancy in an Urban Setting in Zimbabwe. Open Access Library Journal 2019; 6(05):1.
  26. Ruma M, Boggess K, Moss K, Jared H, Murtha A, Beck J, et al. Maternal periodontal disease, systemic inflammation, and risk for preeclampsia. American journal of obstetrics and gynecology 2008; 198(4):389-e1.
  27. Horton AL, Boggess KA, Moss KL, Jared HL, Beck J, Offenbacher S. Periodontal disease early in pregnancy is associated with maternal systemic inflammation among African American women. Journal of periodontology 2008; 79(7):1127-32.
  28. Ozgoli G, Mohsenpour O, Shakeri N, Frouzanfar A, Nik-khoo MH. Evaluation of the relationship between Periodontal disease and Gestational Diabetes Mellitus in pregnant women referred to selected public health centers of Mashhad in 2011. Iran J Obstet Gynecol Infertil 2015; 18(143):11-6.
  29. Bassani DG, Olinto MT, Kreiger N. Periodontal disease and perinatal outcomes: A case‐control study. Journal of clinical periodontology 2007; 34(1):31-9.
  30. Moore S, Ide M, Coward PY, Randhawa M, Borkowska E, Baylis R, et al. A prospective study to investigate the relationship between periodontal disease and adverse pregnancy outcome. British dental journal 2004; 197(5):251-8.
  31. Gomes‐Filho IS, da Cruz SS, Rezende EJ, da Silveira BB, Trindade SC, Passos JS, et al. Periodontal status as predictor of prematurity and low birth weight. Journal of public health dentistry 2006; 66(4):295-8.
  32. Jaiman G, Nayak PA, Sharma S, Nagpal K. Maternal periodontal disease and preeclampsia in Jaipur population. Journal of Indian Society of Periodontology 2018; 22(1):50-54.
  33. Huang X, Wang J, Liu J, Hua L, Zhang D, Hu T, et al. Maternal periodontal disease and risk of preeclampsia: a meta-analysis. Journal of Huazhong University of Science and Technology [Medical Sciences] 2014; 34(5):729-35.
  34. Soucy-Giguère L, Tétu A, Gauthier S, Morand M, Chandad F, Giguère Y, et al. Periodontal disease and adverse pregnancy outcomes: a prospective study in a low-risk population. Journal of Obstetrics and Gynaecology Canada 2016; 38(4):346-50.
  35. Ha JE, Jun JK, Ko HJ, Paik DI, Bae KH. Association between periodontitis and preeclampsia in never‐smokers: a prospective study. Journal of clinical periodontology 2014; 41(9):869-74.
  36. Srinivas SK, Sammel MD, Stamilio DM, Clothier B, Jeffcoat MK, Parry S, et al. Periodontal disease and adverse pregnancy outcomes: is there an association?. American journal of obstetrics and gynecology 2009; 200(5):497-e1.
  37. Lafzi A, Eskandari A, Abolfazli N, Khashabi E, Golmohammadi S. Relationship between preeclampsia and periodontal disease. Journal of Advanced Periodontology & Implant Dentistry 2018; 3(2):79-82.
  38. Daalderop LA, Wieland BV, Tomsin K, Reyes L, Kramer BW, Vanterpool SF, et al. Periodontal disease and pregnancy outcomes: overview of systematic reviews. JDR Clinical & Translational Research 2018; 3(1):10-27.
  39. Wei BJ, Chen YJ, Yu L, Wu B. Periodontal disease and risk of preeclampsia: a meta-analysis of observational studies. PLoS One 2013; 8(8):e70901.
  40. Horton AL, Boggess KA, Moss KL, Beck J, Offenbacher S. Periodontal disease, oxidative stress, and risk for preeclampsia. Journal of periodontology 2010; 81(2):199-204.
  41. Maboudi A, Milani S. Preeclampsia and periodontal diseases: A Review Study. Journal of Mazandaran University of Medical Sciences 2016; 26(137):224-34.
  42. Offenbacher S, Lin D, Strauss R, McKaig R, Irving J, Barros SP, et al. Effects of periodontal therapy during pregnancy on periodontal status, biologic parameters, and pregnancy outcomes: a pilot study. Journal of periodontology 2006; 77(12):2011-24.
  43. Ebrahimzadeh Akbad MH, Ansari Moghaddam S, Sakhavar N. An evaluation of the association between periodontal disease and preeclampsia in pregnant women. Journal of Babol University of Medical Sciences 2018; 20(11):58-62.
  44. Yaghini J, Mostajeran F, Afshari E, Naghsh N. Is periodontal disease related to preeclampsia? Dental research journal 2012; 9(6):770-3.
  45. Lohsoonthorn V, Kungsadalpipob K, Chanchareonsook P, Limpongsanurak S, Vanichjakvong O, Sutdhibhisal S, et al. Maternal periodontal disease and risk of preeclampsia: a case–control study. American journal of hypertension 2009; 22(4):457-63.
  46. Khader YS, Jibreal M, Al‐Omiri M, Amarin Z. Lack of association between periodontal parameters and preeclampsia. Journal of periodontology 2006; 77(10):1681-7.
  47. Taghzouti N, Xiong X, Gornitsky M, Chandad F, Voyer R, Gagnon G, et al. Periodontal disease is not associated with preeclampsia in Canadian pregnant women. Journal of periodontology 2012; 83(7):871-7.
  48. Sumathy V, Suryakirnmayi R, Padmanaban S, Reddy S. Study on association of maternal periodontitis and preeclampsia. Int. J. Clinical Obstetrics & Gynaecology 2018; 2:32-5.
  49. Rahimi SF, Rabiei M, Darvish NS, Habibi O. Evaluation of relation betwean periodontal disease and preeclampsia in pregnant women. Journal of Medical Council of I.R.I. 2013; 31(3):231-6.
  50. Krishna M, Dasar PL. Principles and practice of public health dentistry. Jaypee Brothers Medical Pub; 2010.
  51. Varshney S, Gautam A. Poor periodontal health as a risk factor for development of pre-eclampsia in pregnant women. Journal of Indian Society of Periodontology 2014; 18(3):321-25.
  52. Hoseini M, sarlati F, Sayar F, SHariatmadar ahmadi R, mo'men R. Effect Of Phase I Periodontal Therapy On Prevention Of Preeclampsia. J Res Dent Sci 2011; 8(3):115-119
  53. Bi WG, Emami E, Luo ZC, Santamaria C, Wei SQ. Effect of periodontal treatment in pregnancy on perinatal outcomes: a systematic review and meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine 2019: 1-10.
  54. Govindasamy R, Periyasamy S, Narayanan M, Balaji VR, Dhanasekaran M, Karthikeyan B. The influence of nonsurgical periodontal therapy on the occurrence of adverse pregnancy outcomes: A systematic review of the current evidence. Journal of Indian Society of Periodontology 2020; 24(1):7-14.
  55. Nguyen JG, Nanayakkara S, Holden AC. Knowledge, Attitudes and Practice Behaviour of Midwives Concerning Periodontal Health of Pregnant Patients. International journal of environmental research and public health 2020; 17(7):2246.