Holistic approach during pregnancy: systemic impairments and their impact on oral health
DOI:
https://doi.org/10.21270/archi.v10i8.5428Keywords:
Gingivitis, Pregnancy, Periodontitis, Oral HealthAbstract
Several physiological, immunological and hormonal changes occur during pregnancy and when they are associated with maternal systemic impairments, they may have a synergistic effect on the oral health of pregnant women. This study aimed to synthesize the current scientific evidence of higher quality about the association between systemic impairments and oral health during pregnancy. From August/2020 to March/2021, the following databases were accessed: EMBASE, SCOPUS, MEDLINE (Entrez PubMed), Web of Science, BVS/LILACS and SCIELO. Studies published between January/2000 to March/2021 in Spanish, English and/or Portuguese were included. Due to the immunological and hormonal changes of pregnancy, gingivitis and periodontitis are the most prevalent oral diseases during this period. Systemic impairments during pregnancy that are commonly associated with damage to the oral cavity are: anemia, overweight/obesity, excessive gestational weight gain, diabetes mellitus and arterial hypertension. In addition, systemic and periodontal disorders in pregnancy may harm the health of newborns. However, obesity and periodontitis, despite being associated, may have antagonistic effects on the health of newborns, since obesity is associated with macrosomia and maternal periodontitis is associated with prematurity and low birth weight. In conclusion, several systemic impairments are associated with the worst parameters of oral health during pregnancy and these factors, together or isolated, may result in adverse perinatal outcomes, affecting mothers’ and babies’ health.
Downloads
References
Karin-Kujundzic V, Sola IM, Predavec N, Potkonjak A, Somen E, Mioc P, et al. Novel Epigenetic Biomarkers in Pregnancy-Related Disorders and Cancers. Cells. 2019;8:1459.
Silva de Araujo Figueiredo C, Gonçalves Carvalho Rosalem C, Costa Cantanhede AL, Abreu Fonseca Thomaz ÉB, Fontoura Nogueira da Cruz MC. Systemic alterations and their oral manifestations in pregnant women. J Obstet Gynaecol Res. 2017;43:16-22.
Manrique-Corredor EJ, Orozco-Beltran D, Lopez-Pineda A, Quesada JA, Gil-Guillen VF, Carratala-Munuera C. Maternal periodontitis and preterm birth: Systematic review and meta-analysis. Community Dent Oral Epidemiol. 2019;47:243-51.
Figuero E, Han YW, Furuichi Y. Periodontal diseases and adverse pregnancy outcomes: Mechanisms. Periodontol 2000. 2020;83:175-88.
Foratori-Junior GA, da Silva BM, da Silva Pinto AC, Honório HM, Groppo FC, de Carvalho Sales-Peres SH. Systemic and periodontal conditions of overweight/obese patients during pregnancy and after delivery: a prospective cohort. Clin Oral Investig. 2020;24:157-65.
Genco RJ, Graziani F, Hasturk H. Effects of periodontal disease on glycemic control, complications, and incidence of diabetes mellitus. Periodontol 2000. 2020;83:59-65.
Jesuino BG, Foratori-Junior GA, Missio ALT, Mascoli LS, Sales-Peres SHC. Periodontal status of women with excessive gestational weight gain and the association with their newborns' health. Int Dent J. 2020;70:396-404.
Caracho RA, Foratori-Junior GA, Fusco NDS, Jesuino BG, Missio ALT, Sales-Peres SHC. Systemic conditions and oral health-related quality of life of pregnant women of normal weight and who are overweight. Int Dent J. 2020;70:287-95.
Foratori-Junior GA, Missio ALT, Orenha ES, de Carvalho Sales-Peres SH. Systemic Condition, Periodontal Status, and Quality of Life in Obese Women During Pregnancy and After Delivery. Int Dent J. 2021;71:420-8.
Acharya S, Bhat PV. Oral-health-related quality of life during pregnancy. J Public Health Dent. 2009;69:74-7.
Acharya S, Bhat PV, Acharya S. Factors affecting oral health-related quality of life among pregnant women. Int J Dent Hyg. 2009; 7:102-7.
Geevarghese A, Baskaradoss JK, Sarma PS. Oral Health-Related Quality of Life and Periodontal Status of Pregnant Women. Matern Child Health J. 2017;21:1634-42.
Shah AF, Batra M, Qureshi A. Evaluation of impact of pregnancy on oral health status and oral health related quality of life among women of Kashmir Valley. J Clin Diagn Res. 2017;11:ZC01-ZC04. Retraction in: J Clin Diagn Res. 2018;12:ZZ01.
Wandera MN, Engebretsen IM, Rwenyonyi CM, Tumwine J, Astrøm AN; PROMISE-EBF Study Group. Periodontal status, tooth loss and self-reported periodontal problems effects on oral impacts on daily performances, OIDP, in pregnant women in Uganda: a cross-sectional study. Health Qual Life Outcomes. 2009;7:89.
Lu HX, Xu W, Wong MC, Wei TY, Feng XP. Impact of periodontal conditions on the quality of life of pregnant women: a cross-sectional study. Health Qual Life Outcomes. 2015;13:67.
Moimaz SA, Rocha NB, Garbin AJ, Garbin CA, Saliba O. Influence of oral health on quality of life in pregnant women. Acta Odontol Latinoam. 2016;29:186-93.
Reis DM, Pitta DR, Ferreira HM, de Jesus MC, de Moraes ME, Soares MG. Educação em saúde como estratégia de promoção de saúde bucal em gestantes. Cienc saúde coletiva. 2010;15:269-76.
Costa EM, Azevedo JAP, Martins RFM, Alves CMC, Ribeiro CCC, Thomaz EBAF. Anemia and Dental Caries in Pregnant Women: a Prospective Cohort Study. Biol Trace Elem Res. 2017;177:241-50.
Oskovi-Kaplan ZA, Ozgu-Erdinc AS. Management of Gestational Diabetes Mellitus. Adv Exp Med Biol. 2021;1307:257-72.
Geib LTC. Determinantes sociais da saúde do idoso. Cienc saude coletiva. 2012;17:123-33.
Selwitz RH, Ismail AI, Pitts NB. Dental caries. Lancet. 2007;369:51-9.
Kateeb E, Momany E. Dental caries experience and associated risk indicators among Palestinian pregnant women in the Jerusalem area: a cross-sectional study. BMC Oral Health. 2018;18:170.
Foratori GA Junior, Andrade FJ, Mosquim V, Sales Peres MC, Ceneviva R, Chaim EA, Sales Peres SH. Presence of Serum Ferritin before and after Bariatric Surgery: Analysis in Dentate and Edentulous Patients. PLoS One. 2016;11:e0164084.
World Health Organization. Obesity: Preventing and managing the global epidemic. Geneva: World Health Organization; 2000. p. 1-252. Available from: http://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/.
Yu Z, Han S, Zhu J, Sun X, Ji C, Guo X. Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight/obesity: a systematic review and meta-analysis. PLoS One. 2013;8:e61627.
Li G, Kong L, Li Z, Zhang L, Fan L, Zou L, et al. Prevalence of macrosomia and its risk factors in china: a multicentre survey based on birth data involving 101,723 singleton term infants. Paediatr Perinat Epidemiol. 2014;28:345-50.
El Rafei R, Abbas HA, Charafeddine L, Nakad P, Al Bizri A, Hamod D, et al. Association of pre-pregnancy body mass index and gestational weight gain with preterm births and fetal size: an observational study from Lebanon. Paediatr Perinat Epidemiol. 2016;30:38-45.
Zilberlicht A, Feferkorn I, Younes G, Damti A, Auslender R, Riskin-Mashiah S. The mutual effect of pregestational body mass index, maternal hyperglycemia and gestational weight gain on adverse pregnancy outcomes. Gynecol Endocrinol. 2016;32:416-20.
Gao X, Yan Y, Xiang S, Zeng G, Liu S, Sha T, et al. The mutual effect of pre-pregnancy body mass index, waist circumference and gestational weight gain on obesity-related adverse pregnancy outcomes: A birth cohort study. PLoS One. 2017;12:e0177418.
Buchanan TA, Xiang AH, Page KA. Gestational diabetes mellitus: risks and management during and after pregnancy. Nat Rev Endocrinol. 2012;8:639-49.
Tan HC, Roberts J, Catov J, Krishnamurthy R, Shypailo R, Bacha F. Mother's pre-pregnancy BMI is an important determinant of adverse cardiometabolic risk in childhood. Pediatr Diabetes. 2015;16:419-26.
Moura-Grec PG, Marsicano JA, Carvalho CA, Sales-Peres SH. Obesity and periodontitis: systematic review and meta-analysis. Cien Saude Colet. 2014;19:1763-72.
Keller A, Rohde JF, Raymond K, Heitmann BL. Association between periodontal disease and overweight and obesity: a systematic review. J Periodontol. 2015;86:766-76.
Khan S, Barrington G, Bettiol S, Barnett T, Crocombe L. Is overweight/obesity a risk factor for periodontitis in young adults and adolescents?: a systematic review. Obes Rev. 2018;19:852-83.
Chapper A, Munch A, Schermann C, Piacentini CC, Fasolo MT. Obesity and periodontal disease in diabetic pregnant women. Braz Oral Res. 2005;19:83-7.
Piscoya MD, Ximenes RA, Silva GM, Jamelli SR, Coutinho SB. Periodontitis-associated risk factors in pregnant women. Clinics (Sao Paulo). 2012;67:27-33.
Vogt M, Sallum AW, Cecatti JG, Morais SS. Factors associated with the prevalence of periodontal disease in low-risk pregnant women. Reprod Health. 2012;9:3.
Lee HJ, Jun JK, Lee SM, Ha JE, Paik DI, Bae KH. Association between obesity and periodontitis in pregnant females. J Periodontol. 2014;85:e224-31.
Xie Y, Xiong X, Elkind-Hirsch KE, Pridjian G, Maney P, Delarosa RL, et al. Prepregnancy obesity and periodontitis among pregnant females with and without gestational diabetes mellitus. J Periodontol. 2014;85:890-8.
Zambon M, Mandò C, Lissoni A, Anelli GM, Novielli C, Cardellicchio M, et al. Inflammatory and Oxidative Responses in Pregnancies With Obesity and Periodontal Disease. Reprod Sci. 2018;25:1474-84.
Fusco NDS, Foratori-Junior GA, Missio ALT, Jesuino BG, Sales-Peres SHC. Systemic and oral conditions of pregnant women with excessive weight assisted in a private health system. Int Dent J. 2019;69:472-9.
Foratori-Junior GA, Jesuino BG, Caracho RA, Orenha ES, Groppo FC, Sales-Peres SHC. Association between excessive maternal weight, periodontitis during the third trimester of pregnancy, and infants' health at birth. J Appl Oral Sci. 2020;28:e20190351.
Rath SR, Marsh JA, Newnham JP, Zhu K, Atkinson HC, Mountain J, et al. Parental pre-pregnancy BMI is a dominant early-life risk factor influencing BMI of offspring in adulthood. Obes Sci Pract. 2016;2:48-57.
Institute of Medicine (US) and national research council (US) committee to reexamine IOM pregnancy weight guidelines. Weight gain during pregnancy: reexamining the guidelines. Washington: The National Academies Collection: Reports funded by National Institutes of Health, 2009.
Catalano PM. Obesity, insulin resistance, and pregnancy outcome. Reproduction. 2010;140:365-71.
Artal R, Catanzaro RB, Gavard JA, Mostello DJ, Friganza JC. A lifestyle intervention of weight-gain restriction: diet and exercise in obese women with gestational diabetes mellitus. Appl Physiol Nutr Metab. 2007;32:596-601.
Abariga SA, Whitcomb BW. Periodontitis and gestational diabetes mellitus: a systematic review and meta-analysis of observational studies. BMC Pregnancy Childbirth. 2016;16:344.
Kumar A, Sharma DS, Verma M, Lamba AK, Gupta MM, Sharma S, et al. Association between periodontal disease and gestational diabetes mellitus-A prospective cohort study. J Clin Periodontol. 2018;45:920-31.
Xiong X, Elkind-Hirsch KE, Vastardis S, Delarosa RL, Pridjian G, Buekens P. Periodontal disease is associated with gestational diabetes mellitus: a case-control study. J Periodontol 2009;80:1742-9.
Özçaka Ö, Ceyhan-Öztürk B, Gümüş P, Akcalı A, Nalbantsoy A, Buduneli N. Clinical periodontal status and inflammatory cytokines in gestational diabetes mellitus. Arch Oral Biol 2016;11:87-91.
Kintiraki E, Papakatsika S, Kotronis G, Goulis DG, Kotsis V. Pregnancy-Induced hypertension. Hormones (Athens). 2015;14:211-23.
Berhe AK, Ilesanmi AO, Aimakhu CO, Mulugeta A. Effect of pregnancy induced hypertension on adverse perinatal outcomes in Tigray regional state, Ethiopia: a prospective cohort study. BMC Pregnancy Childbirth. 2019;20:7.
Martin-Cabezas R, Seelam N, Petit C, Agossa K, Gaertner S, Tenenbaum H, et al. Association between periodontitis and arterial hypertension: A systematic review and meta-analysis. Am Heart J. 2016;180:98-112.
Muñoz Aguilera E, Suvan J, Buti J, Czesnikiewicz-Guzik M, Barbosa Ribeiro A, Orlandi M, et al. Periodontitis is associated with hypertension: a systematic review and meta-analysis. Cardiovasc Res. 2020;116:28-39.
Pralhad S, Thomas B, Kushtagi P. Periodontal disease and pregnancy hypertension: a clinical correlation. J Periodontol. 2013;84:1118-25.
Zhao R, Xu L, Wu ML, Huang SH, Cao XJ. Maternal pre-pregnancy body mass index, gestational weight gain influence birth weight. Women Birth. 2018;31:e20-e25.
