Correlation between periodontal disease, inflammatory alterations and pre-eclampsia.

ABSTRACT

BACKGROUND AND OBJECTIVE: Several studies have hypothesized that periodontal disease may increase the risk of pre-eclampsia. The correlation between the two diseases would probably be based on hypertension-related cytokine release in the local periodontal environment. The aim of this study was to evaluate the association between periodontal disease and pre-eclampsia, and the correlation of the two conditions with interleukin-6 (IL-6) and tumor necrosis factor-α(TNFα) mRNA expression. MATERIAL AND METHODS: A case-control analysis of 116 pregnant women, 58 with pre-eclampsia (cases) and 58 normotensive pregnant women (controls) was performed. In addition to collection of socio-demographic data and periodontal evaluation, peripheral blood samples were collected for laboratory analysis of IL-6 and TNFα mRNA expression by real-time PCR. RESULTS: There was an association between periodontitis and pre-eclampsia (adjusted odds ratio 3.73; 95% confidence interval 1.32-10.58). Increased TNFα mRNA expression was observed in pre-eclamptic women; however, there was no correlation between periodontitis and systemic cytokine expression. In the case group, systemic cytokine mRNA levels were similar in pregnant women with and without periodontitis (means±SD) 0.73±0.24 vs. 0.82±0.38 for TNFα and 1.31±1.49 vs. 1.09±0.74 for IL-6, respectively. CONCLUSION: Periodontitis was clinically related to pre-eclampsia; however, the supposed mechanism that correlates the two diseases, i.e. a systemic inflammatory process involving cytokines TNFα and IL-6 in the presence of periodontal disease, could not be confirmed in this study.