Objective: To demonstrate the role of periodontal treatment (PT) in the prevention of preterm delivery (PD). Methods: A comparative prospective study of two groups of pregnant women with threatening PD was carried out at the Department of Obstetrics and Gynaecology of the University of Szeged: group A (n = 39) comprised patients who were merely examined dentally for periodontitis, and group B (n = 44) consisted of patients who received periodontal treatment during pregnancy. Results: Periodontitis was identified in 19 cases (48.7%) in group A and in 18 cases (40.9%) in group B. The mean birth weight of the newborns was significantly higher in group B (3,009.1 g) than in group A (2,580.8 g; p = 0.007). The rate of premature birth was significantly lower in the group who received PT (p = 0.012, odds ratio = 3.5, 95% confidence interval = 1.38–8.86). Conclusions: The PT of pregnant women can decrease the rate of premature birth and consequently lead to a better neonatal health outcome.

Absztrakt: Bevezetés: A terhesség alatti fogágybetegségek és az azok szülészeti következményei közötti összefüggések elemzése egyre szélesebb körben kutatott és bővülő témakör. A páciensek megfelelő szájhigiénia iránti motivációja és szükséges esetben a biztonságosan és hatékonyan kivitelezhető professzionális szájhigiénés kezelések kiemelt pontjai kell, hogy legyenek a várandósgondozásnak. Célkitűzés: A jelen tanulmányban a terhesség alatt elvégzett professzionális szájhigiénés kezelés hatásait elemeztük, szülészeti szempontokból. Módszer: A szerzők a fenyegető koraszülés miatt megfigyelt terhesek esetében prospektív randomizált tanulmányban vetették össze a csak fogászati szűrésen (n = 71), illetve ezzel egy időben fogászati kezelésen is (n = 79) átesett várandósok szülészeti mutatóit. Statisztikai analízis: A kezelt és nem kezelt csoportok egyszerű összehasonlítását kategorikus változók esetében khi-négyzet-, míg folytonos változók esetében t-próbával végeztük. A perinatológiai kimenetel kategorikus faktorainak elemzése esetén a változók egybevetésekor kapott kockázati esélyhányadosok összehasonlítása a gingivitises és krónikus fogágybetegségben szenvedő terheseknél Mantel–Haenszel-próbával történt. A kezelés hatékonyságát befolyásoló tényezők összehasonlításában többváltozós logisztikus regressziót alkalmaztunk. A statisztikai szignifikancia határát 5%-ban határoztuk meg. Eredmények: A krónikus fogágybetegségben szenvedő terheseknél, a kezelésen átesett csoportban az újszülöttek súlya szignifikánsan magasabb volt, mint a nem kezelteknél (2990 ± 582,3 g vs 2568,1 ± 699,1 g, p = 0,005). A szülésnél észlelt terhességi kor a fogágybetegségben szenvedőknél kezelés hatására szignifikánsan magasabb volt, mint a nem kezelt csoportban (37,3 ± 1,9 vs 36 ± 2,9 hét, p = 0,027). A kezelés hatására a terhességi kor prolongálását észleltük mindkét csoportban, kifejezettebb szignifikanciaértékkel a gingivitisszel rendelkezők esetében, mint a krónikus fogágybetegségben szenvedőknél (p = 0,02 vs p = 0,043). Következtetés: A terhesség alatt elvégzett fogászati kezeléseknek jótékony hatásuk volt a terhesség prolongálására, és ilyen módon a koraszülés okozta perinatalis szövődmények csökkentésére. Orv Hetil. 2018; 159(24): 978–984. Introduction: Correlations between periodontitis and its effects on the outcome of pregnancies are actually more focused topics. Maternal motivation for a good oral hygiene and preventive dental treatment must be highlighted tasks during pregnancy care. Aim: The authors analysed the effect of the preventive dental treatment during pregnancy and its obstetrical effects. Method: In a prospective randomised study, including pregnant women observed for threatening preterm deliveries, patients with dental examination (n = 71) were compared with patients undergoing dental treatment at the same time (n = 79). Statistical analysis: Univariate comparisons for categorical variables were assessed by χ2 tests and independent Student’s t-tests for continuous variables. ORs were compared with Mantel–Haenszel tests. Multivariable logistic regression was performed to evaluate the factors determining the poor periodontal parameters and gingivitis separately. The two-tailed statistical significance level was set at 5%. Results: In the dental treatment group, the neonatal birth weight was significantly higher than in the non-treated group, in case of patients with periodontitis (2990 ± 582.3 g vs 2568.1 ± 699.1 g, p = 0.005). Also the average age at delivery was significantly higher in the treated vs non-treated groups (37.3 ± 1.9 vs 36.0 ± 2.9 weeks, p = 0.027), and the treatment had a beneficial effect on the prolongation of pregnancy, with a higher level of significance in the gingivitis group vs patients with periodontitis groups (p = 0.02 vs p = 0.043). Conclusions: Dental treatment of expecting women has a beneficial effect on the prolongation of pregnancy by decreasing the rate of prematurity and perinatal complications. Orv Hetil. 2018; 159(24): 978–984.

Purpose: The aim of the present study was to analyse the role of the main diagnostic signs of poor periodontal status, probing depth (PD) ≥4 mm and bleeding on probing (BOP) ≥50%, both simultaneously and individually in preterm birth (PB) and their effect on the birth weight (BW). Prematurity ...

Background and Objectives: Preterm birth as a complex phenomenon is influenced by numerous endogenic and exogenic factors, although its exact cause often remains obscure. According to epidemiological studies, maternal periodontal diseases, in addition to affecting general health, can also cause adverse pregnancy outcomes. Nonetheless, the existing results in the literature regarding this topic remain controversial. Consequently, our study aimed to determine the connection between poor maternal periodontal status and neonatal birth weight. Materials and Methods: A total of 111 primigravida–primiparous pregnant, healthy women underwent a periodontal examination in the second trimester of their pregnancies. Probing depth (PD) and bleeding on probing (BOP) were determined, and based on these diagnostic measurements, the patients were divided into three subgroups according to their dental status: healthy (H, n = 17), gingivitis (G, n = 67), and periodontitis (P, n = 27). Results: Considering that poor maternal oral status is an influencing factor for obstetrical outcomes, the presence of PD and BOP (characterized by the sulcus bleeding index, SBI) was evaluated. In the case of P, defined as PD ≥ 4 mm in at least one site and BOP ≥ 50% of the teeth, a significant correlation between BOP and a low neonatal birth weight at delivery (p = 0.001) was found. An analysis of the relationship between SBI and gestational age (GA) at the time of the periodontal examination in the different dental status groups showed a significant correlation between these parameters in the G group (p = 0.04). Conclusions: Our results suggest that a worse periodontal status during pregnancy may negatively affect obstetrical outcomes, especially the prematurity rate and newborn weight. Therefore, the importance of periodontal screening to prevent these complications is undeniable.

Introduction: Gestational physiology is characterized by an expansion of plasma volume and an elevation in cardiac output. Given the scarcity of existing data on pregnancy-related left atrial (LA) volumetric and functional features, this study aims to define LA volumes, volume-based functional properties and strains in healthy subjects during mid-term pregnancy. Methods: The present study comprised 19 healthy women in mid-term pregnancy (mean age: 30.5 ± 2.7 years, weight: 81.7 ± 14.0 kg, height: 166.9 ± 5.7 cm) without any symptoms, known diseases or other conditions, which could affect the results. Their results were compared to those of 43 healthy non-pregnant women (mean age: 28.6 ± 4.9 years, weight: 59.9 ± 8.5 kg, height: 167.8 ± 7.6 cm). All participants underwent comprehensive two-dimensional Doppler echocardiography with three-dimensional speckle-tracking echocardiography (3DSTE). Results: Thicker interventricular septum, increased left ventricular ejection fraction and impaired early and late transmitral flow velocities could be detected in healthy pregnant subjects as compared to those of non-pregnant individuals. End-systolic maximum LA volume was increased with elevated stroke volume and emptying fraction. While early diastolic LA volume was preserved with elevated stroke volume and emptying fraction, late diastolic LA volume, stroke volume and emptying fraction remained unchanged. However, indexed LA volumes did not differ between the groups. Among end-systolic peak global LA strains, only LA longitudinal strain (LS) was increased, while all others remained unchanged. Among regional strains, basal, midatrial and superior LA circumferential strain (CS) and LA-LS were increased except for basal LA-CS, which was impaired. Among late diastolic LA strains at atrial contraction, none of them showed any significant changes in healthy pregnant subjects compared with those of non-pregnant women. Conclusions: With a detailed 3DSTE study, elevated end-systolic LA volume and preserved diastolic LA volumes, together with enhanced end-systolic LA reservoir and early diastolic LA conduit functional properties, could be detected with features of preserved late diastolic booster pump function in healthy women during mid-term pregnancy (second trimester). When comparing indexed LA volumes, no significant difference could be confirmed between the pregnant and non-pregnant groups. This suggests that the increased end-systolic LA volume may be an adaptation to increased body weight.