Gum disease linked to preemies

Prof. Charlene Africa
Prof. Charlene Africa
The research, by Prof Charlene Africa of the Department of Medical Biosciences, University of the Western Cape, is beginning to show a link between pregnancy-associated periodontal (gum) disease, namely gingivitis and periodontitis (inflammatory conditions affecting the support structures of the teeth), and preterm deliveries (PTD).

Up to 20-30% of preterm deliveries can possibly be traced back to bacteria produced by pregnancy-associated gingivitis, says Africa.

This adds to a growing body of evidence internationally that gum disease may be linked to various systemic problems i.e. conditions in other parts of the body, including cardiovascular disease and cancer.

Read more: Tooth loss ups risk for heart disease

Gum disease common in pregnant women

Africa has found that periodontal disease, caused by an overgrowth of oral bacteria, or plaque, occurs in 50-70% of pregnant women.

Her research is focused on the "red complex", a group of three bacteria associated with periodontal disease. These are Treponema denticola, Porphyromonas gingivalis and Tannerella forsythia. She’s also interested in the particularly aggressive Aggregatibacter actinomycetemcomitans, a bacterium associated with preterm deliveries in Rwanda and other parts of Africa.

In a recent study in Cape Town, Africa collected plaque samples from over 400 mothers and also looked at their delivery records, confirming an association between periodontal disease and PTD.

She and her team collected vaginal swab samples from maternal obstetrics clinics in Gugulethu, Khayelitsha, Mitchells Plain and Mowbray. She hopes to use the findings to determine biomarkers – measurable characteristics that can serve as early indicators – for preterm delivery.

Mouth bacteria enter the bloodstream

Disease-causing bacteria associated with infected gums can enter the bloodstream, travelling to the uterus and triggering the production of prostaglandins, hormone-like lipids (important building blocks of cells) derived from fatty acids.

Besides controlling inflammation, prostaglandins may play a part in childbirth by prompting contractions of the smooth muscle of the uterus, inducing "cervical ripening", the softening of the cervix in preparation for labour and delivery. Bacterial infection increases the production of prostaglandins, increasing the risk for PTD.

Get gingivitis treated

“Gingivitis can be treated, safely, during the second trimester of pregnancy,” says Africa, “making it even more important for pregnant women to report any oral difficulty to a gynaecologist or obstetrician.”

The World Health Organisation states that over 60% of preterm births occur in Africa and South Asia, but that it is a global problem. In the lower-income countries, on average, 12% of babies are born too soon compared with 9% in higher-income countries. Within countries, poorer families are at higher risk.”

Read more:
Poor diet linked to preterm births
How clean is your mouth?
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