Background: Periodontitis is a chronic inflammatory disease that may worsen during pregnancy and has been linked to adverse outcomes (APOs) such as preeclampsia (PE), gestational diabetes mellitus (GDM), and preterm birth (PTB). However, the causal relationship remains unclear. The primary objective of this systematic review is to analyze the available scientific evidence in order to investigate the possible relationship between periodontitis during pregnancy and maternal outcomes. The secondary objectives are: to understand the potential mechanisms of interaction and the role of periodontal health in the management and prevention of pregnancy complications. Methodos: A systematic literature review was conducted following PRISMA guidelines, searching PubMed, Scopus, and Google Scholar (December 2024 – February 2025). A total of 2,326 articles were initially identified. After applying inclusion and exclusion criteria, screening, and full-text assessment, 16 studies were considered eligible and included in the final analysis. Eligible studies investigated pregnant women diagnosed with periodontitis and at least one outcome of interest (PE, GDM, PTB). Results: Findings show a strong and highly significant association between periodontitis and PE, with up to a fourfold increased risk in cohort studies and up to sixfold in low-income countries. Similarly, women with periodontitis had up to twice the risk of developing GDM, confirming a possible bidirectional relationship between the two conditions. Regarding PTB, periodontitis is a risk fator, it was associated with nearly a twofold higher risk. However, the methodological quality of the studies is heterogeneous and frequently limited, especially with regard to the definition of periodontitis, thus reducing the possibility of establishing a definite causal link. Regarding the effect of periodontal treatment on the prevention of APO, it is still uncertain. Conclusion: Current evidence supports the association between periodontitis and adverse pregnancy outcomes, particularly PE, GDM, and PTB. Preventive strategies and multidisciplinary management are crucial. Further prospective and randomized trials are needed to clarify underlying mechanisms and assess the effectiveness of early periodontal treatment. Keywords: Periodontitis; Pregnancy; Preeclampsia; Gestational diabetes mellitus; Preterm birth; Systematic review.
Background: La parodontite è una malattia infiammatoria cronica che può peggiorare durante la gravidanza, ed è stata associata a esiti avversi (APO) come preeclampsia (PE), diabete mellito gestazionale (DGM) e parto pretermine (PPT). Tuttavia, il nesso causale non è ancora completamente chiarito. L’obiettivo primario di questa revisione sistematica è analizzare le evidenze scientifiche disponibili al fine di indagare la possibile relazione tra la parodontite in gravidanza ed esiti materni. Gli obiettivi secondari sono: comprendere i potenziali meccanismi di interazione e il ruolo della salute parodontale nella gestione e prevenzione delle complicanze della gravidanza. Metodi: È stata condotta una revisione sistematica della letteratura secondo le linee guida PRISMA, consultando PubMed, Scopus e Google Scholar (dicembre 2024 – febbraio 2025). Inizialmente sono stati identificati un totale di 2.326 articoli. Dopo il processo di screening, l’applicazione dei criteri di inclusione ed esclusione e la valutazione full-text, sono stati selezionati 16 studi ritenuti idonei e inclusi nell’analisi finale. Gli studi ammissibili hanno esaminato donne in gravidanza con diagnosi di parodontite e almeno un esito di interesse (PE, GDM, PPT). Risultati: Dalla sintesi dei dati emerge un’associazione significativa tra parodontite e PE, con un aumento del rischio fino a quattro volte negli studi di coorte e fino a sei volte nei Paesi a basso reddito. Analogamente, la parodontite si associa a un incremento fino a due volte del rischio di DGM, evidenziando una possibile relazione bidirezionale tra le due patologie. Per il PPT, le donne con parodontite presentano un fattore di rischio, quasi doppio di PPT. Tuttavia, la qualità metodologica degli studi risulta eterogenea e frequentemente limitata, soprattutto per quanto riguarda la definizione della parodontite, riducendo così la possibilità di stabilire un nesso causale certo. Riguardo l’effetto del trattamento parodontale sulla prevenzione delle APO è ancora incerto. Conclusioni: La letteratura supporta l’associazione tra parodontite ed esiti avversi della gravidanza, in particolare PE, DGM e PPT, sottolineando l’importanza di strategie preventive e di un approccio multidisciplinare. Sono necessari studi prospettici e randomizzati di alta qualità per confermare i meccanismi eziopatogenetici e valutare l’efficacia del trattamento parodontale precoce. Keywords: Parodontite; Gravidanza; Preeclampsia; Diabete mellito gestazionale; Parto pretermine; Revisione sistematica.
La parodontite e gli esiti materni in gravidanza: una revisione della letteratura.
PIROLI BENEDETTI, LORENA
2024/2025
Abstract
Background: Periodontitis is a chronic inflammatory disease that may worsen during pregnancy and has been linked to adverse outcomes (APOs) such as preeclampsia (PE), gestational diabetes mellitus (GDM), and preterm birth (PTB). However, the causal relationship remains unclear. The primary objective of this systematic review is to analyze the available scientific evidence in order to investigate the possible relationship between periodontitis during pregnancy and maternal outcomes. The secondary objectives are: to understand the potential mechanisms of interaction and the role of periodontal health in the management and prevention of pregnancy complications. Methodos: A systematic literature review was conducted following PRISMA guidelines, searching PubMed, Scopus, and Google Scholar (December 2024 – February 2025). A total of 2,326 articles were initially identified. After applying inclusion and exclusion criteria, screening, and full-text assessment, 16 studies were considered eligible and included in the final analysis. Eligible studies investigated pregnant women diagnosed with periodontitis and at least one outcome of interest (PE, GDM, PTB). Results: Findings show a strong and highly significant association between periodontitis and PE, with up to a fourfold increased risk in cohort studies and up to sixfold in low-income countries. Similarly, women with periodontitis had up to twice the risk of developing GDM, confirming a possible bidirectional relationship between the two conditions. Regarding PTB, periodontitis is a risk fator, it was associated with nearly a twofold higher risk. However, the methodological quality of the studies is heterogeneous and frequently limited, especially with regard to the definition of periodontitis, thus reducing the possibility of establishing a definite causal link. Regarding the effect of periodontal treatment on the prevention of APO, it is still uncertain. Conclusion: Current evidence supports the association between periodontitis and adverse pregnancy outcomes, particularly PE, GDM, and PTB. Preventive strategies and multidisciplinary management are crucial. Further prospective and randomized trials are needed to clarify underlying mechanisms and assess the effectiveness of early periodontal treatment. Keywords: Periodontitis; Pregnancy; Preeclampsia; Gestational diabetes mellitus; Preterm birth; Systematic review.| File | Dimensione | Formato | |
|---|---|---|---|
|
Tesi Ufficiale.pdf
Accesso riservato
Dimensione
603.75 kB
Formato
Adobe PDF
|
603.75 kB | Adobe PDF |
The text of this website © Università degli studi di Padova. Full Text are published under a non-exclusive license. Metadata are under a CC0 License
https://hdl.handle.net/20.500.12608/97661