The relationship between periodontitis and preeclampsia: A systematic review

Document Type : Review Article


1 Assistant professor, Department of Prosthodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.

2 PhD in Dentistry, Tehran Islamic Azad University of Medical Sciences, Tehran, Iran.

3 Assistant professor, Department of Oral and Dental Diseases, School of Dentistry, Ardabil University, Ardabil, Iran.

4 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

5 Student of Periodontitis, School of Dentistry, Tehran Islamic Azad University of Medical Sciences, Tehran, Iran.


Introduction: For various reasons, such as the lack of focus on studies on the relationship between periodontitis and preeclampsia, as well as the small number of people who develop preeclampsia after periodontitis, scattered research has been conducted in different parts of the world. They are not collected regularly so that researchers can have the results together; therefore, this study was performed with aim to investigate the relationship between periodontitis and preeclampsia to assess the role of periodontitis as an independent factor in preeclampsia.
Methods: This systematic review study was performed in 2020 with searching for keywords of preeclampsia, periodontitis, periodontal, pregnancy complications, pregnancy outcomes, relationship and treatment (Based on Mesh) in databases of PubMed, Scopus, Google Scholar, SID, IranDoc, Web of Sciences, Science Direct, OVID and Springer without time limit among the published articles in Persian and English and their information was recorded in a checklist designed for this research.
 Results: Out of 759 articles found, only 9 (6 cohort articles and 3 clinical trial articles) were included in the study. Five cohort articles confirmed that periodontitis could lead to preeclampsia, and three clinical trial articles found no association between treatment of periodontitis and reduction of preeclampsia.
Conclusion: Periodontitis can be effective in preventing diseases during pregnancy; the role of this variable in preeclampsia has not been determined precisely, but the results of studies suggest that periodontitis may lead to preeclampsia; the results of this study should be used with caution.


  1. AlJehani YA. Risk factors of periodontal disease: review of the literature. International journal of dentistry 2014; 2014.
  2. Haghdoost M, Mousavi S, Gol MK, Montazer M. Frequency of Chlamydia trachomatis infection in spontaneous abortion of infertile women during first pregnancy referred to tabriz university of medical sciences by nested PCR method in 2015. International Journal of Women's Health and Reproduction Sciences 2019; 7(4):526-30.
  3. Ferreira MC, Dias‐Pereira AC, Branco‐de‐Almeida LS, Martins CC, Paiva SM. Impact of periodontal disease on quality of life: a systematic review. Journal of periodontal research 2017; 52(4):651-65.
  4. Dioguardi M, Crincoli V, Laino L, Alovisi M, Sovereto D, Mastrangelo F, et al. The role of periodontitis and periodontal bacteria in the onset and progression of Alzheimer’s disease: a systematic review. Journal of clinical medicine 2020; 9(2):495.
  5. Baeza M, Morales A, Cisterna C, Cavalla F, Jara G, Isamitt Y, et al. Effect of periodontal treatment in patients with periodontitis and diabetes: systematic review and meta-analysis. Journal of Applied Oral Science 2020; 28.
  6. Patini R, Staderini E, Lajolo C, Lopetuso L, Mohammed H, Rimondini L, et al. Relationship between oral microbiota and periodontal disease: A systematic review. Eur Rev Med Pharmacol Sci 2018; 22(18):5575-88.
  7. Martinez-Herrera M, Silvestre-Rangil J, Silvestre FJ. Association between obesity and periodontal disease. A systematic review of epidemiological studies and controlled clinical trials. Medicina oral, patologia oral y cirugia bucal 2017; 22(6):e708.
  8. Kc S, Wang XZ, Gallagher JE. Diagnostic sensitivity and specificity of host‐derived salivary biomarkers in periodontal disease amongst adults: systematic review. Journal of clinical periodontology 2020; 47(3):289-308.
  9. Wu P, Haththotuwa R, Kwok CS, Babu A, Kotronias RA, Rushton C, et al. Preeclampsia and future cardiovascular health: a systematic review and meta-analysis. Circulation: Cardiovascular Quality and Outcomes 2017; 10(2):e003497.
  10. El-Sayed AA. Preeclampsia: A review of the pathogenesis and possible management strategies based on its pathophysiological derangements. Taiwanese Journal of Obstetrics and Gynecology 2017; 56(5):593-8.
  11. Andraweera PH, Lassi ZS. Cardiovascular risk factors in offspring of preeclamptic pregnancies—systematic review and meta-analysis. The Journal of pediatrics 2019; 208:104-13.
  12. Fox R, Kitt J, Leeson P, Aye CY, Lewandowski AJ. Preeclampsia: risk factors, diagnosis, management, and the cardiovascular impact on the offspring. Journal of clinical medicine 2019; 8(10):1625.
  13. Riché EL, Boggess KA, Lieff S, Murtha AP, Auten RL, Beck JD, et al. Periodontal disease increases the risk of preterm delivery among preeclamptic women. Annals of periodontology 2002; 7(1):95-101.
  14. Boggess KA, Lieff S, Murtha AP, Moss K, Beck J, Offenbacher S. Maternal periodontal disease is associated with an increased risk for preeclampsia. Obstetrics & Gynecology 2003; 101(2):227-31.
  15. 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.
  16. Shetty M, Shetty PK, Ramesh A, Thomas B, Prabhu S, Rao A. Periodontal disease in pregnancy is a risk factor for preeclampsia. Acta obstetricia et gynecologica Scandinavica 2010; 89(5):718-21.
  17. Kumar A, Begum N, Prasad S, Lamba AK, Verma M, Agarwal S, et al. Role of cytokines in development of pre‐eclampsia associated with periodontal disease–Cohort Study. Journal of clinical periodontology 2014; 41(4):357-65.
  18. 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.
  19. Vickers NJ. Animal communication: when i’m calling you, will you answer too?. Current biology 2017; 27(14):R713-5.
  20. Michalowicz BS, Hodges JS, DiAngelis AJ, Lupo VR, Novak MJ, Ferguson JE, et al. Treatment of periodontal disease and the risk of preterm birth. New England Journal of Medicine 2006; 355(18):1885-94.
  21. Offenbacher S, Beck JD, Jared HL, Mauriello SM, Mendoza LC, Couper DJ, et al. Effects of periodontal therapy on rate of preterm delivery a randomized controlled trial. Obstetrics and gynecology 2009; 114(3):551.
  22. Newnham JP, Newnham IA, Ball CM, Wright M, Pennell CE, Swain J, et al. Treatment of periodontal disease during pregnancy: a randomized controlled trial. Obstetrics & Gynecology 2009; 114(6):1239-48.
  23. 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.
  24. 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.
  25. Shetty MS, Ramesh A, Shetty PK, Agumbe P. Salivary and serum antioxidants in women with preeclampsia with or without periodontal disease. The Journal of Obstetrics and Gynecology of India 2018; 68(1):33-8.
  26. Sumathy V, Suryakirnmayi R, Padmanaban S, Reddy S. Study on association of maternal periodontitis and preeclampsia. J Obstet Gynaecol 2018; 2(5):32-5.
  27. Khalighinejad N, Aminoshariae A, Kulild JC, Mickel A. Apical periodontitis, a predictor variable for preeclampsia: a case-control study. Journal of endodontics 2017; 43(10):1611-4.
  28. Gare J, Kanoute A, Meda N, Viennot S, Bourgeois D, Carrouel F. Periodontal Conditions and Pathogens Associated with Pre-Eclampsia: A Scoping Review. International journal of environmental research and public health 2021; 18(13):7194.
  29. Bobetsis YA, Graziani F, Gürsoy M, Madianos PN. Periodontal disease and adverse pregnancy outcomes. Periodontology 2000. 2020; 83(1):154-74.