Serum inflammatory mediators in pregnancy: Changes after periodontal treatment and association with pregnancy outcomes

Bryan S. Michalowicz, M. John Novak, James S. Hodges, Anthony DiAngelis, William Buchanan, Panos N. Papapanou, Dennis A. Mitchell, James E. Ferguson, Virginia Lupo, James Bofill, Stephen Matseoane, Michelle Steffen, Jeffrey L. Ebersole

Research output: Contribution to journalArticlepeer-review

44 Scopus citations


Background: The purposes of this study were to determine: 1) if periodontal treatment in pregnant women before 21 weeks of gestation alters levels of inflammatory mediators in serum; and 2) if changes in these mediators are associated with birth outcomes. Methods: A total of 823 pregnant women with periodontitis were randomly assigned to receive scaling and root planing before 21 weeks of gestation or after delivery. Serum obtained between 13 and 16 weeks, 6 days (study baseline) and 29 to 32 weeks of gestation was analyzed for C-reac-tive protein; prostaglandin E2; matrix metalloproteinase-9; fibrinogen; en-dotoxin; interleukin (IL)-1β, -6, and -8, and tumor necrosis factor-α. Cox regression, multiple linear regression, and the t, x 2, and Fisher exact tests were used to examine associations among the biomarkers, periodontal treatment, and gestational age at delivery and birth weight. Results: Atotalof 796 women had baseline serum data, and 620 women had baseline and follow-up serum and birth data. Periodontal treatment did not significantly alter the level of any biomarker (P >0.05). Neither baseline levels nor the change from baseline in any biomarker were significantly associated with preterm birthor infant birth weight (P>0.05). Intreatment subjects, the change in endotoxin was negatively associated with the change in probing depth (P <0.05). Conclusions: Non-surgical mechanical periodontal treatment in pregnant women, delivered before 21 weeks of gestation, did not reduce systemic (serum) markers of inflammation. In pregnant women with peri-odontitis, levels of these markers at 13 to 17 weeks and 29 to 32 weeks of gestation were not associated with infant birth weight or a risk for preterm birth.

Original languageEnglish (US)
Pages (from-to)1731-1741
Number of pages11
JournalJournal of periodontology
Issue number11
StatePublished - 2009


  • Cytokines
  • Inflammation
  • Periodontitis
  • Pregnancy
  • Preterm birth


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