Relationship between periodontal diseases and ascending bacterial infection with preterm delivery

Background: There is an association between periodontal diseases and preterm delivery. Aim: To assess the relationship between periodontal disease, ascending bacterial infection and placental pathology with preterm delivery. Patients and methods: A periodontal examination and collection of amniotic fluid and subgingial plaque samples were performed in women with preterm labor with intact membranes, without an evident clinical cause of preterm premature rupture of membranes, without clinical chorioamnionitis or labor and a gestational age between 24 and 34 weeks. Microbial invasion of the amniotic cavity was defined as the presence of a positive amniotic fluid culture. Cervicovaginal infection was defined as a bacterial vaginosis or positive culture of cervix or vagina with a high neutrophil count. Ascending bacterial infection was diagnosed as the microbial invasion of the amniotic cavity by ascending bacteria or cervicovaginal infection. Corioamnionitis, funisitis or vellositis were diagnosed. Results: Fifty-nine women were included: forty-two with preterm labor with intact membranes and seventeen with preterm premature rupture of membranes. The prevalence of periodontal diseases was 93.2%. Microbial invasion of the amniotic fluid was detected in 27.1% of patients. Periodontal pathogenic bacteria were isolated in 18.6% of amniotic fluid samples and 71.2% of subgingival plaque samples. The prevalence of ascending bacterial infection was 83.1% and in 72.9% of women it was associated with periodontal disease. Preterm delivery (<37 weeks) occurred in 64.4% of patients and was significantly associated with generalized periodontal disease and with the association of ascending bacterial infection and periodontal disease. Patients with preterm delivery and generalized periodontal disease had a higher frequency of chorioamnionitis and funisitis. Conclusions: Generalized periodontal disease and its association with ascending bacterial infection are related to preterm delivery and placental markers of bacterial ascending infection (Rev Med Chile 2009; 137: 504-14).