北京地区母亲牙周状况与早产低出生体重新生儿的关系

目的 初步评价北京地区人群中母亲牙周状况与早产低出生体重新生儿的关系.方法 对2004年1月至2005年12月在北京市4家医院分娩的83例早产低体重新生儿(preterm low birth weight,PLBW)的母亲(PLBW组)以及44名正常新生儿(normal birth weight,NBW)的母亲(NBW组)进行牙周临床指标的检查.所有受检者均全身健康.检查指标包括:菌斑指数(plaque index,PLI)、探诊深度(probing depth,PD)、临床附着丧失(attachment loss,AL)和出血指数(bleeding index,BI).结果 中度慢性牙周炎及侵袭性牙周炎母亲发生PLBW的风险是牙龈炎或轻度慢性牙周炎母亲的4.26倍.PLBW组与NBW组PD≥4 mm位点率(分别为8.1%和6.9%)、AL≥2 mm 位点率(分别为12.8%和6.1%)和BOP(+)位点率(分别为70.4%和66.9%),PLBW组均显著高于NBW组(P值分别小于0.01、0.001、0.01).结论 本组人群中母亲的牙周状况与PLBW之间可能存在关联,较差的牙周状况可能是发生PLBW的危险因素之一.     

母体牙周炎与早产低体重儿关系的研究进展

早产低体重儿(preterm low birth weight,PLBW)是指妊娠时间不足37周,体重不足2500 g的新生儿。据统计,早产约占所有分娩人数的5%-15%,,是当前围产儿死亡的主要原因,约有2/3—3/4围产儿死亡及患病与早产有关,比足月产儿高11-16倍。由于过早分娩,中断了胎儿在宫内的正常生长发育,约有1/4的PLBW留有神经或智力方面的后遗症。因此,防治PLBW是降低围产儿死亡率,提高新生儿质量的主要举措之一。     

牙周炎与早产低出生体重儿

牙周炎可作为早产低出生体重儿(PLBWI)的一个可能的病原因素。虽然25%～50%的PLBWI并不知道其确切原因,但是越来越多的证据表明慢性感染在PLBWI的发生中起了重要的作用,炎症反应介导了早产和牙周疾病之间的关系。因此,控制牙周疾病是否能减少PLBWI的发生亦是学者们所要研究的重要内容。下面就牙周炎与PLBWI之间的关系及其可能的机制的最新研究进展作一综述。     

牙周龈下螺旋体和早产低体重儿关系的初探

目的初探牙周状况、龈下螺旋体和早产低体重儿(PLWB)发生之间的关系。方法从住院病例库中按严格标准选出PLWB组(49例)和Control组(20例),电话召回填写调查问卷、单盲检查口腔牙周情况(PLI、BI、PD)并计数指数牙(16、21、24、36、41、44)的CAL和龈下螺旋体比例,用统计学软件处理最终数据。结果PLWB组83.7?L>0,Control组55.0%,P<0.05;两组所有指数牙的PD、CAL和龈下螺旋体比例均为PLWB组大于Control组,P<0.05都是下颌牙位。结论PLWB组牙周破坏倾向于比Control组更重;龈下螺旋体或许可以充当一个粗略的PLWB预示指标。     

牙周炎-早产低体重儿的危险因素

近年来研究表明牙周炎可能是系统性疾病的危险因素,本文对妊娠妇女牙周炎与早产低体重儿的相关关系及其可能机制作一综述,为降低围产儿的死亡率及并发症,提高婴儿生存质量提出新的思路.     

慢性牙周炎孕鼠致早产及低体重新生鼠的动物模型研究

目的通过研究构建的大鼠慢性牙周炎孕鼠动物模型,探讨慢性牙周炎与早产及低体重儿发生的关系。方法将20只wistar雌鼠随机分成2组：正常组麻醉后不作处理,待其苏醒;实验组麻醉后牙周结扎加涂菌。4周后观察牙周情况及牙周组织病理学改变,将两组雌鼠分别以1∶1与雄鼠合笼,制备慢性牙周炎孕鼠导致早产及低体重新生鼠的动物模型,于分娩后观察早产率和新生鼠体重的变化。结果 4周后实验组出现牙槽骨吸收,牙周袋形成的临床症状。组织切片镜下可见大量的破骨细胞,附着丧失。正常组早产率为12.5%,实验组为75%,差异有统计学意义（P〈0.05）;新生鼠的体重组间比较差异有统计学意义（P〈0.05）。结论采用牙周结扎加涂菌的方法建立慢性牙周炎大鼠模型与亚临床型慢性牙周炎相似,可增加早产及低体重新生鼠的发生,该模型可进行慢性牙周炎与早产及低体重儿疾病的发病机制研究。     

牙周病与早产低体重儿风险相关性：一项基于病例-对照研究的Meta分析

目的：采用Meta分析的方法评价牙周病与早产低体重儿（preterm low birth weight,PLBW）发病风险的关系。方法：计算机检索PubMed、Embase、中国知网、万方和中国生物医学文献数据库,检索时限均为从建库至2013年9月30日,同时追溯纳入文献的参考文献。由2位评价者独立筛选文献、提取资料及进行方法学质量评价后,采用RevMan5.2软件进行Meta分析。结果：最终纳入17个病例-对照研究。Meta分析结果显示：暴露于牙周病可以显著增加PLBW发生率3.00倍[OR=3.00,95%CI=（2.05-4.39）,P〈0.001],敏感性分析结果稳健性较好;按种族地区亚组分析显示,美洲人群[OR=3.72,95%CI=（2.10-6.56）,P〈0.001]和亚洲人群[OR=3.28,95%CI=（1.74-6.15）,P=0.0002]罹患PLBW的风险显著高于欧洲人群[OR=1.85,95%CI=（0.94-3.61）,P=0.007]。未检测到明显发表偏倚。结论：当前证据表明牙周炎是PLBW的有意义的危险因素。     

牙周病与早产低出生体重儿关系的临床研究

目的比较分娩早产低出生体重儿(PLBW)的孕妇与足月妊娠正常分娩新生儿(NBW)孕妇的牙周状况及牙周病的发生率,探讨牙周病与PLBW的关系。方法随机选取分娩PLBW的孕妇206例为研究组,选取同期分娩NBW的孕妇209例为对照组,检测两组孕妇的牙周状况,记录菌斑指数(PLI)、探诊深度(PD),临床附着丧失(CAL)和出血指数(BI),并计算牙周炎位点率(PD>3 mm,CAL>2 mm)及牙周病的发生率。结果分娩早产低出生体重儿的孕妇牙周炎位点率(3.3%)和牙周病发生率(81.1%)明显高于对照组(1.4%,35.9%),差异有显著性(P<0.01);牙周炎位点率与孕周和新生儿体重均呈负相关系(P<0.05)。结论牙周病可能是PLBW发生的危险因素。     

牙周病与早产低体重儿的关系及其机制的研究进展

早产是指新生儿出生时胎龄未满37周,低体重儿是指新生儿出生时体重未满2 500 g,早产常伴发低体重儿。早产被认为是新生儿死亡的主要原因。牙周病是一种口腔常见的慢性感染性疾病,与全身多种系统性疾病具有相关性。流行病学资料表明牙周病与早产低体重儿具有一定相关性,牙周病是早产低体重儿等不良妊娠结局的危险因素之一,可能的机制包括牙周致病菌菌体的直接作用,引起机体炎症反应和过激免疫反应等,然而具体的机制尚未明确。本文就牙周病与早产低体重儿的相关性,开展牙周治疗对早产低体重儿发生率的影响,以及牙周病引发早产低体重儿的相关机制作一综述。     

孕产妇牙周疾病与早产低体重儿相关性分析

目的:研究孕产妇牙周疾病与早产低体重儿的相关性. 方法:采用横断面调查的方法,根据随机原则并按照纳入标准抽取2006-05～2007-02间在湖北省妇幼保健院进行生产的已作婚姻登记的,并且孕前1 年内及孕期未曾患有下生殖泌尿系统性疾病的妇女432 名.调查方法包括问卷和临床检查:调查问卷为被调查人员相关情况的结构式问题调查;牙周检查项目包括软垢指数、龈沟出血指数、牙周袋探诊深度及临床附着丧失水平等,同时记录新生儿体重和分娩时孕周.运用卡方检验及Logistic回归分析的统计学方法对数据进行分析.结果:分娩出早产低体重儿的孕产妇53 名,占12.3%;正常分娩的孕产妇379 名,占87.7%.早产低体重组孕产妇牙龈炎的患病率为86.6%,牙周炎的患病率为64.2%,正常分娩组的分别为73.6%和32.7%.患有牙龈炎孕产妇分娩出早产低体重儿的OR值为1.30, 95%CI为0.53～3.22;患有牙周炎的孕产妇分娩出早产低体重儿的OR值为2.69, 95%CI为1.37～5.27.结论:孕产妇牙周疾病是引起早产低体重儿的主要危险因素之一.     

牙周疾病与早产儿及低体重儿相关性的研究进展

妇女在妊娠期间身体和情绪的变化会影响其口腔健康。孕期常见的口腔表现是牙龈炎和牙周炎。牙周疾病与分娩出早产儿(PTB)及低体重儿(LBW)的相关性是近年颇具争议的研究热点。本文就这一方面的研究现状作一综述。     

孕妇牙周病中牙龈卟啉单胞菌和血清炎性因子与早产低体重儿的关系

目的探讨孕妇牙周病中牙龈卟啉单胞菌（P.gingivalis）检出情况、血清炎性因子与早产低体重（PLBW）的关系。方法通过严格筛查分别选取分娩出早产低体重儿的产妇（PLBW组）和正常分娩的产妇各30例（对照组）,对其牙周状况进行检查,记录菌斑指数（PI）、出血指数（BI）、探诊深度（PD）及临床附着丧失水平（CAL）,并采集产妇龈下菌斑、静脉血和脐带血,采用16S rRNA PCR法检测菌斑中P.gingivalis,酶联免疫吸附试验（ELISA）检测血清中白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）和前列腺素E2 （ PGE2）水平。结果PLBW组牙周状况较差,P.gingivalis在PLBW组和对照组中检出率分别为56.7%和30.0%,两者差异有统计学意义（P<0.05）。牙周病变程度、P.gingivalis检出率与胎儿孕周和出生体重均呈弱负相关（P<0.05）。PLBW组静脉血和脐带血中IL-1β、IL-6、PGE2水平均较对照组高;PLBW组内患有牙周病者静脉血中IL-1β、PGE2含量高于牙周健康者（P<0.01）。结论孕妇牙周感染可能是导致早产低体重儿的原因之一。     

The association between maternal periodontitis and low birth weight infants among Malay women

Abstract – Objectives: Maternal periodontitis has been suggested as one of the risk factors for low birth weight (LBW) infants. The objective of this study was to determine the association between maternal periodontitis and LBW infants among Malay women. Methods: Screening periodontal examinations were carried out on all eligible Malay pregnant women in the second trimester of pregnancy attending two randomly selected community maternal and child health clinics in Kota Bharu, Kelantan. Patients with four or more sites with pocket depth 4 mm or higher, and clinical attachment loss 3 mm or higher at the same site with presence of bleeding on probing were diagnosed as having periodontitis in this study. Using this definition, systematic random sampling was utilized for selection of 250 subjects for each exposed and non‐exposed group. Of 500 subjects enrolled in the study, 28 (5.6%) were either dropped or lost to follow‐up. Of the remaining 472 subjects, 232 with periodontitis were in the exposed group and 240 with healthy periodontium were in the nonexposed group. Results: The incidence of LBW was 14.2% (95% CI: 9.70–18.75) in women with periodontitis, and 3.3% (95% CI: 1.05–5.62) in women without periodontitis. The relative risk of having LBW infants was 4.27 times higher for women with periodontitis compared with those without periodontitis (95% CI: 2.01–9.04). After adjustment for potential confounders using multiple logistic regression analysis, significant association was found between maternal periodontitis and LBW (OR = 3.84; 95% CI: 1.34–11.05). Conclusion: The results of this study provide additional evidence that pregnant women with periodontitis are at a significantly higher risk of delivering LBW infants.     

Association between periodontitis and low birth weight: a case-control study

OBJECTIVE: To verify a possible association between periodontitis and low-birth-weight babies. MATERIAL AND METHODS: One hundred and fifty-one mothers were examined. The case group included 76 mothers (mean age 25.6 years), whose babies at birth weighed <2500 g and had a gestational age (GA) <37 weeks, while 75 mothers (mean age 24.4 years), whose babies were born with a weight of >2500 g and with a GA>37 weeks, were the control group. Data from the mothers and the babies were collected from the Hospital registration records and during an interview with the mother. The periodontal examination included measurements of probing pocket depth (PPD) and clinical attachment loss (CAL) in six sites from all existing teeth, except for third molars. Mothers with periodontitis had at least four sites with PPD> or =4 and CAL> or =3 mm, while healthy mothers had PPD< or =3 mm and CAL< or =1 mm. RESULTS: The median number of sites with PPD> or =4 and CAL> or =3 mm was eight in the case group, and four in the control group. The significant associations with low birth weight (LBW) babies were periodontitis (odds ratio (OR)=3.48, 95% confidence interval (CI): 1.17; 10.36), arterial hypertension (OR=9.65, 95% CI: 2.22; 41.91), haemorrhage during pregnancy (OR=10.88, 95% CI: 1.95; 60.53), number of pre-natal examinations (OR=0.10, 95% CI: 0.02; 0.43) and genitourinary infection (OR=3.21, 95% CI: 1.25; 8.20). CONCLUSION: Periodontitis was considered a risk indicator for LBW in this sample, similar to other risk factors already recognized by obstetricians.     

Periodontal status and preterm low birth weight: a case control study

BACKGROUND: Previous studies have suggested that periodontal disease may be an important risk factor for preterm low birth weight. However, the link between periodontal health status of pregnant women and preterm low birth weight is contentious, as recent studies found no association between periodontitis and pregnancy outcome. OBJECTIVE: The aim of this study was to investigate this potential link in a German Caucasian population. METHODS: Fifty-nine pregnant women with a high risk for a preterm low birth weight infant (suffering from preterm contractions, cases, group 1) as well as 42 control women with no preterm contractions during pregnancy and having an infant appropriate for date and weight (>or= 37 weeks gestation, >or= 2500 g, group 2) were examined. Clinical periodontal status was recorded on a full mouth basis. Subgingival plaque samples were taken and periodontal pathogens were identified by polymerase chain reaction. Additionally, interleukin-1 beta level in gingival crevicular fluid was analysed. RESULTS: The mean percentage of sites showing moderate to advanced attachment loss (>or=3 mm) was low in all study groups (group 1: 9.9 +/- 11.2%; group 2:10.6 +/- 14.1%, respectively). No significant differences between the groups in any aspects of the studied periodontitis parameters could be detected. Using a logistic regression model controlling for known preterm low birth weight risk factors, no periodontitis-associated factors increased risk for preterm contractions or preterm low birth weight. The odds ratio (OR) was 1.19 for preterm contractions, the 95% confidence interval (CI) 0.46; 3.11 and 0.73 for preterm low birth weight; 95% CI: 0.13; 4.19, respectively. CONCLUSION: In this population, periodontitis was not a detectable risk factor for preterm low birth weight in pregnant women.