scholarly journals Periodontal Pathogens and Preterm Birth: Current Knowledge and Further Interventions

Pathogens ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 730
Author(s):  
Milan Terzic ◽  
Gulzhanat Aimagambetova ◽  
Sanja Terzic ◽  
Milena Radunovic ◽  
Gauri Bapayeva ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Preterm Labor ◽  
Current Knowledge ◽  
Neonatal Morbidity ◽  
Epidemiological Studies ◽  
Oral Bacteria ◽  
Periodontal Pathogens ◽  
Periodontal Bacteria ◽  
Adverse Pregnancy ◽  
Tract Infections

Preterm labor is defined as a birth before 37 weeks of gestation and occurs in 5–20% of pregnancies. Preterm labor, as multifactorial entity associated with a high risk of neonatal morbidity and mortality, is influenced by maternal, fetal and environmental factors. Microbiological studies suggest that infectious pathogens may account for 25–40% of preterm birth. Infections of different sites, like genital, urinary tract infections, and pneumonia, are linked to the preterm labor. The most recent epidemiological studies consistently report that maternal periodontal disease is associated with preterm delivery, as well as the association between the presence of pathogenic oral bacteria in the placenta and adverse pregnancy outcomes. On the other hand, some previously published papers found periodontal bacteria in placentas of term pregnancies. In spite of a huge research done on the topic, both experimental and clinical, there are many controversial opinions about the role of periodontal infections in preterm birth. Thus, this comprehensive review addresses this very important topic and evaluates novel strategies of preventive and therapeutic approaches.

scholarly journals Preterm Birth Is Correlated With Increased Oral Originated Microbiome in the Gut

2021 ◽  
Vol 11 ◽  
Author(s):  
Chunhua Yin ◽  
Jingrui Chen ◽  
Xuena Wu ◽  
Yeling Liu ◽  
Quan He ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gut Microbiome ◽  
Preterm Labor ◽  
Amplicon Sequencing ◽  
Oral Bacteria ◽  
Gut Bacteria ◽  
Oral Microbiome ◽  
16S Rrna Amplicon Sequencing ◽  
Threatened Preterm Labor ◽  
Adverse Pregnancy

BackgroundPreterm birth is one of the leading causes of perinatal morbidity and mortality. Gut microbiome dysbiosis is closely related to adverse pregnancy outcomes. However, the role of the gut microbiome in the pathogenesis of preterm birth remains poorly studied.MethodWe collected fecal samples from 41 women (cases presenting with threatened preterm labor =19, 11 of which delivered preterm; gestational age-matched no-labor controls, all of which delivered at term = 22) were recruited for the study. We performed 16S rRNA amplicon sequencing to compare the composition of the gut microbiome in threatened preterm labor cases and controls and among women who delivered preterm and at term. By annotating taxonomic biomarkers with the Human Oral Microbiome Database, we observed an increased abundance of potential oral-to-gut bacteria in preterm patients.ResultsPatients with preterm birth showed a distinct gut microbiome dysbiosis compared with those who delivered at term. Opportunistic pathogens, particularly Porphyromonas, Streptococcus, Fusobacterium, and Veillonella, were enriched, whereas Coprococcus and Gemmiger were markedly depleted in the preterm group. Most of the enriched bacteria were annotated oral bacteria using the Human Oral Microbiome Database. These potential oral-to-gut bacteria were correlated with clinical parameters that reflected maternal and fetal status.ConclusionsThis study suggests that patients who deliver preterm demonstrate altered gut microbiome that may contain higher common oral bacteria.

Integrated Review of Cytokines in Maternal, Cord, and Newborn Blood: Part I—Associations With Preterm Birth

2009 ◽  
Vol 11 (4) ◽  
pp. 371-376 ◽  
Author(s):  
Debra Lyon ◽  
Ching-Yu Cheng ◽  
Lois Howland ◽  
Debra Rattican ◽  
Nancy Jallo ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Proinflammatory Cytokines ◽  
Preterm Labor ◽  
Neonatal Morbidity ◽  
The United States ◽  
Fetal Outcome ◽  
Fetal Outcomes ◽  
Consistent Finding ◽  
Mediators Of Inflammation ◽  
Adverse Pregnancy

Preterm birth (PTB; spontaneous delivery prior to 37 weeks gestation) affects one out of eight infants born in the United States and is the most common cause of neonatal morbidity and mortality. Although the pathogenesis of PTB is multifactorial, a growing body of literature supports the hypothesis that one cause of PTB is inflammation in pregnancy. Investigators have implicated mediators of inflammation, most notably proinflammatory cytokines, as being associated with and perhaps a playing a causal role in the pathogenesis of preterm labor and adverse early fetal outcomes. Though researchers have pursued the association of cytokines with preterm labor and subsequent early adverse fetal outcomes as a line of research, there has been little integration of diverse findings across studies. This systematic review appraises the empirical evidence from human studies for the association of levels of cytokines in blood with preterm labor and adverse early fetal outcome to examine the current state of the science in this important area of biobehavioral research. The most consistent finding is that increased levels of proinflammatory cytokines, particularly interleukin (IL) 6, IL-β1, and tumor necrosis factor α (TNF-α), are associated with PTB as compared to levels found at term birth. However, there have been relatively few studies and results have not been consistent. Therefore, further research is needed to elucidate the association of these inflammatory mediators with adverse pregnancy outcomes.

scholarly journals Heat Shock Proteins and Heat Shock Protein-Antibody Complexes in Placental Tissues

1999 ◽  
Vol 7 (4) ◽  
pp. 180-185 ◽  
Author(s):  
M. Ziegert ◽  
S. S. Witkin ◽  
I. Sziller ◽  
H. Alexander ◽  
E. Brylla ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Heat Shock ◽  
Heat Shock Proteins ◽  
Pregnancy Outcome ◽  
Preterm Labor ◽  
Adverse Pregnancy Outcome ◽  
Increased Risk ◽  
Circulating Antibodies ◽  
Adverse Pregnancy ◽  
Shock Proteins

Objective:The relationship between pregnancy outcome and expression of the heat shock proteins (hsps) or hsp-antibody complexes of 60kD (hsp60), 70kD (hsp70), and 90kD (hsp90) in placental tissue and circulating antibodies to hsps was evaluated.Method:Expression of hsp60, hsp70, and hsp90 in placentae from 12 women with preterm birth, eight with intrauterine growth restriction (IUGR), and 10 with term birth, as well as the presence of the corresponding antibodies, was investigated by a new carbocyanine double fluorescence technique. Results were compared with microbiological findings and circulating antibodies to hsps in sera.Results:In each placental specimen examined, hsp60, hsp70, and hsp90 were identified. However, hsp70-antibody complexes were detected in only four of the preterm labor cases. Similarly, hsp60-antibody complexes were detected in only five preterm labor patients and in one patient with IUGR. None of the placentae contained hsp90-antibody complexes. In the preterm birth group, all patients with hsp60-antibody complexes were also positive for circulating antibodies to hsp60. The presence of hsp70-antibody complexes also correlated with hsp70 antibody in sera.Conclusions:Formation of hsp60- and hsp70-antibody complexes in the placenta may contribute to the induction of preterm birth. Women sensitized to these antibodies may be at increased risk for adverse pregnancy outcome. Infect. Dis. Obstet. Gynecol. 7:180–185, 1999.

scholarly journals UMA ANÁLISE INTEGRAL DO TRABALHO DE PARTO PREMATURO

2019 ◽  
Vol 6 (1) ◽  
pp. 54-57
Author(s):  
Renata dos Santos Oliveira ◽  
Maria Luiza Silva Brito ◽  
Delcides Bernardes da Costa Neto
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Early Diagnosis ◽  
Preterm Labor ◽  
Transvaginal Ultrasound ◽  
Treatment Options ◽  
Neonatal Morbidity ◽  
Morbidity And Mortality ◽  
Fetal Fibronectin ◽  
Appropriate Treatment

A prematuridade é um dos mais significativos desafios da obstetrícia, constituindo a principal causa de morbimortalidade neonatal. A presença de fatores de risco, tanto maternos quanto fetais, geram maior vigilância durante o decorrer da gestação, entretanto cada gravidez ocorre de forma singular e seus fatores devem ser analisados individualmente, motivo que nos leva ao estudo profundo e integral de cada um deles. O diagnóstico do trabalho de parto prematuro é eminentemente clínico e, muitas vezes, de difícil estabelecimento precoce. Para auxiliar na obtenção de um diagnóstico em estágio inicial, tem-se empregado métodos complementares, como o ultrassom transvaginal e a fibronectina fetal. Existem várias opções de tratamento com suas particularidades para a indicação, porém a escolha deve ser feita prontamente a fim de prolongar a gestação, evitando os desfechos desfavoráveis do parto prematuro. Palavras-chave: trabalho de parto prematuro; diagnóstico precoce; tratamento adequado ABSTRACT Prematurity is one of the most significant challenges of obstetrics, being the main cause of neonatal morbidity and mortality. The presence of risk factors, both maternal and fetal, generate greater vigilance during the course of gestation, however each pregnancy occurs in a singular way and its factors must be analyzed individually, reason that leads us to the deep and integral study of each one of them. The diagnosis of preterm labor is eminently clinical and often difficult to establish early. To assist in obtaining an early diagnosis, complementary methods have been employed, such as transvaginal ultrasound and fetal fibronectin. There are several treatment options with their particularities for the indication, but the choice must be made promptly in order to prolong the gestation, avoiding the unfavorable outcomes of the preterm birth. Keywords: preterm labor; early diagnosis; appropriate treatment.

scholarly journals Oral Microbiome and Preterm Birth: Correlation or Coincidence? A Narrative Review

2020 ◽  
Vol 8 (F) ◽  
pp. 123-132
Author(s):  
Biagio Rapone ◽  
Elisabetta Ferrara ◽  
Nicola Montemurro ◽  
Ilaria Converti ◽  
Matteo Loverro ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Oral Bacteria ◽  
Oral Microbiome ◽  
Periodontal Pathogen ◽  
Oral Microbiota ◽  
Periodontal Pathogens ◽  
Medline Search ◽  
Phylogenetic Community Structure ◽  
Inflammatory Status ◽  
Periodontal Infection

BACKGROUND: Physiological changes that occur during pregnancy involve, as a natural consequence, also modifications of oral microbiome. However, the addition with microbial imbalance due to pre-existing periodontal infection might impair a pathological alteration in the phylogenetic community structure and composition in the oral cavity, exacerbating an inflammatory status, and becoming a potential risk factor for preterm birth. From the empirical findings about the relationship between periodontal pathogens and systemic diseases, a clear interest focused on the potential impact of some periodontal pathogens on the preterm birth risk has emerged. AIM: Exploration of the potential interdependence existing between dysbiosis of oral microbiome and changes in maternal-fetal barrier in premature rupture of membranes. MATERIALS AND METHODS: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a Medline search was performed for studies focusing on oral microbioma and its association with pre-term birth, and completed by additional hand searching. Two reviewers independently selected studies and extracted data. The search was restricted to only reports written in English. RESULTS: The electronic search produced 66 items. Six duplicates were found. Among the collected studies, 56 were discarded because they met the exclusion criteria. The articles and reports in our review showed a connection between preterm birth and altered oral microbiome, suggesting a potential key role of Fusobacterium nucleatum, a notable periodontal pathogen involved in several pathological periodontal conditions, in increasing the risk of premature birth. CONCLUSIONS: Since F. nucleatum is frequently associated with preterm birth, it is coherent to hypothesize a potential role for the oral microbiota for preterm birth risk. Further studies should be carried out to determine the changes of the oral microflora in pregnancy and to provide comprehensive knowledge of the diversity of oral bacteria involved in preterm birth.

scholarly journals Placental Ageing in Adverse Pregnancy Outcomes: Telomere Shortening, Cell Senescence, and Mitochondrial Dysfunction

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Samprikta Manna ◽  
Cathal McCarthy ◽  
Fergus P. McCarthy
Keyword(s):  
Oxidative Stress ◽  
Mitochondrial Dysfunction ◽  
Pregnancy Outcomes ◽  
Current Knowledge ◽  
Neonatal Morbidity ◽  
Adverse Pregnancy Outcomes ◽  
Premature Ageing ◽  
Dna Mutations ◽  
Critical Organ ◽  
Adverse Pregnancy

Preeclampsia is a multisystemic pregnancy disorder and a major cause of maternal and neonatal morbidity and mortality worldwide. The exact pathophysiology of preeclampsia remains unclear; however, it is speculated that the various pathologies can be attributed to impaired vascular remodelling and elevated oxidative stress within the placenta. Oxidative stress plays a key role in cell ageing, and the persistent presence of elevated oxidative stress precipitates cellular senescence and mitochondrial dysfunction, resulting in premature ageing of the placenta. Premature ageing of the placenta is associated with placental insufficiency, which reduces the functional capacity of this critical organ and leads to abnormal pregnancy outcomes. The changes brought about by oxidative insults are irreversible and often lead to deleterious modifications in macromolecules such as lipids and proteins, DNA mutations, and alteration of mitochondrial functioning and dynamics. In this review, we have summarized the current knowledge of placental ageing in the aetiology of adverse pregnancy outcomes and discussed the hallmarks of ageing which could be potential markers for preeclampsia and fetal growth restriction.

Progesterone Gel and Placebo were Equally Effective in Preventing Preterm Birth Among Women with Preterm Labor

2021 ◽  
Author(s):  
Ylva Vladic Stjernholm ◽  
Tomislav Vladic ◽  
Giovanna Marchini
Keyword(s):  
Preterm Birth ◽  
Preterm Labor ◽  
Neonatal Intensive Care ◽  
Maintenance Treatment ◽  
Controlled Trial ◽  
Neonatal Morbidity ◽  
Control Group ◽  
Pathogen Invasion ◽  
Prolonged Pregnancy ◽  
Randomised Controlled

Abstract Introduction The aim of this trial was to evaluate the effect of maintenance treatment with vaginal progesterone gel compared to placebo in preventing preterm birth after the onset of preterm labor.Methods A randomised controlled trial in Sweden in 2009 − 18. Women with preterm labor were randomized to daily doses of progesterone gel 90 mg (n = 29) or placebo (n = 29) after standard treatment with intravenous tocolytics. Women with intravenous tocolytics alone served as controls.Results The latency to delivery was 58 ± 34 days with progesterone and 64 ± 51 days with placebo (p = 0.83), compared to 2 ± 2 days in the control group (progesterone and placebo vs control p < 0.001). The rate of preterm birth before 34 weeks was 34 % after progesterone and 38 % after placebo (p = 0.34) compared to 100 % in the control group (p < 0.001 respectively). The composite neonatal morbidity (p = 0.65) and neonatal intensive care unit admission (p = 0.12) were comparable between the progesterone and placebo groups, but lower in these groups compared neonates of women in the control group (p < 0.001 respectively). Conclusion Maintenance treatment with progesterone gel and placebo were equally effective in preventing preterm birth among women with preterm labor. Both progesterone and placebo prolonged pregnancy more effectively than intravenous tocolysis alone. We hypothesize, that the acidic gel base reinforced the biochemical barrier at the uterine cervix, which counteracted ascending pathogen invasion and subsequent inflammation and thereby delayed preterm birth. The present results suggest, that non-hormonal agents that reinforce the biochemical cervical barrier can be useful for the prevention of preterm birth in clinical practice.

Neonatal Outcomes Differ after Spontaneous and Indicated Preterm Birth

2017 ◽  
Vol 35 (05) ◽  
pp. 494-502 ◽  
Author(s):  
Devyn Demaree ◽  
Emily Merfeld ◽  
Methodius Tuuli ◽  
Jennifer Wambach ◽  
F. Cole ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Preterm Labor ◽  
Primary Outcome ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Respiratory Morbidity ◽  
Preterm Neonates ◽  
Medical Complication ◽  
Respiratory Outcomes ◽  
Preterm Rupture Of Membranes

Objective Preterm birth (PTB) at <37 weeks of gestation complicates 10% of pregnancies and requires accurate counseling regarding anticipated neonatal outcomes. PTB classification as spontaneous or indicated is commonly used to cluster PTB into subtypes, but whether neonatal outcomes differ by PTB subtype is unknown. We tested the hypothesis that neonatal morbidity differs based on subtype of PTB. Methods We performed a retrospective cohort study of live-born, non-anomalous preterm infants from 2004 to 2008. Spontaneous PTB was defined as PTB from spontaneous preterm labor or preterm rupture of membranes. Indicated PTB was defined as PTB from any maternal or fetal medical complication necessitating delivery. The primary outcome was a composite of early respiratory morbidity. Secondary outcomes included late composite respiratory morbidity and other neonatal morbidities. Results Of 1,223 preterm neonates, 60.9% were born after spontaneous PTB and 30.1% after indicated PTB. Composite early respiratory morbidity was significantly higher after indicated PTB versus spontaneous PTB (1.3, 95% confidence interval [CI] 1.2–1.4). Composite late respiratory morbidity (1.8, 95% CI 1.3–2.3) and neonatal death (2.8, 95% CI 1.5–5.1) were also significantly higher after indicated PTB versus spontaneous PTB. Conclusion Neonatal respiratory outcomes and death differ according to PTB subtype. PTB subtype should be considered while counseling families and anticipating neonatal outcomes after PTB.

scholarly journals Pathogenesis to Treatment: Preventing Preterm Birth Mediated by Infection

1997 ◽  
Vol 5 (2) ◽  
pp. 106-114 ◽  
Author(s):  
James A. McGregor ◽  
Janice I. French
Keyword(s):  
Preterm Birth ◽  
Preterm Labor ◽  
Inflammatory Responses ◽  
Systemic Treatment ◽  
Preterm Births ◽  
Host Responses ◽  
Obstetrical Care ◽  
Preterm Premature Rupture ◽  
Genital Tract Infections ◽  
Tract Infections

Prevention of preterm birth and subsequent newborn immaturity is a primary goal of obstetrical care worldwide. Accumulated evidence shows that 1) as many as 25–50% of preterm births are caused by common genital tract infections and subsequent maternal/fetal inflammatory responses; 2) microbial and maternal host factors (phospholipases, proteases, etc.) play roles in preterm labor and preterm premature rupture of membranes (pPROM); 3) integrated aspects of maternal and fetal host responses (inflammation, altered immune adaptations, endocrine and paracrine mechanisms) play increasingly understood roles in premature activation of parturition; and 4) identification and systemic treatment of common genitourinary infections, most importantly bacterial vaginosis (BV), reduce the risks of preterm delivery and PROM.

scholarly journals Localization of P. gingivalis in Preterm Delivery Placenta

2009 ◽  
Vol 88 (6) ◽  
pp. 575-578 ◽  
Author(s):  
J. Katz ◽  
N. Chegini ◽  
K.T. Shiverick ◽  
R.J. Lamont
Keyword(s):  
Risk Factor ◽  
Preterm Delivery ◽  
Porphyromonas Gingivalis ◽  
Human Placenta ◽  
Pregnancy Outcomes ◽  
Placental Tissue ◽  
Oral Bacteria ◽  
Periodontal Pathogens ◽  
Decidual Cells ◽  
Adverse Pregnancy

Increasing evidence suggests an association between periodontal disease and adverse pregnancy outcomes. Although infection is considered as a risk factor for preterm delivery, the localization of oral bacteria or their antigens in chorioamnionitis placental tissue has never been demonstrated. This study was devised to test the hypothesis that periodontal pathogens may be present and affect human placenta in cases of chorioamnionitis. Using immunocytochemistry, we have identified the presence of Porphyromonas gingivalis antigens in placental tissues. The antigens were detected in the placental syncytiotrophoblasts, chorionic trophoblasts, decidual cells, and amniotic epithelial cells, as well as the vascular cells. There was a substantial increase in immunostaining intensity of the tissues sectioned from women with chorioamnionitis compared to those experiencing normalterm pregnancy, p < 0.019 (Mann‐Whitney test). These results suggest that P. gingivalis may commonly colonize placental tissue, and that the presence of the organism may contribute to preterm delivery.

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