Skip to main content

Advertisement

SpringerLink
Log in

Systemic and periodontal conditions of overweight/obese patients during pregnancy and after delivery: a prospective cohort

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objective

To evaluate the systemic and periodontal conditions, as well as the determinants of health in pregnant women with and without obesity/overweight during the second and third trimesters of pregnancy and after delivery.

Materials and methods

In the second trimester (T1), 93 pregnant women were divided into two groups with either excessive weight (G1, n = 53) or normal weight (G2, n = 40) and subsequently examined them in the third trimester of pregnancy (T2) and at least 2 months after delivery (T3). The following variables were analyzed: (a) systemic impairments during pregnancy—arterial hypertension (AH) and gestational diabetes mellitus (GDM); (b) oral hygiene behavior; (c) periodontal conditions; (d) anthropometric data and systemic health condition after pregnancy. The Mann-Whitney test, chi-squared test, ANOVA, and binary logistic regression were adopted (p < 0.05).

Results

G1 showed higher frequency of GDM and AH in T1 and T2, respectively (p = 0.047; p = 0.004). Both groups had worse oral hygiene behaviors after delivery. A higher frequency of periodontitis was found in all periods for G1 (p < 0.05). G2 showed improvement of all periodontal parameters after delivery, whereas G1 showed no difference regarding these parameters between time periods.

Conclusion

Pregnant women with excessive weight presented worse systemic and periodontal conditions during pregnancy and after delivery.

Clinical relevance

Low socioeconomic level and overweight/obesity were significant predictors of periodontitis during pregnancy and after delivery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Foratori GA Junior, Andrade FJ, Mosquim V, Sales Peres MC, Ceneviva R, Chaim EA, Sales Peres SH (2016) Presence of serum ferritin before and after bariatric surgery: analysis in dentate and edentulous patients. PLoS One 11:e0164084. https://doi.org/10.1371/journal.pone.0164084

    Article  Google Scholar 

  2. Genco RJ, Grossi SG, Ho A, Nishimura F, Murayama Y (2005) A proposed model linking inflammation to obesity, diabetes, and periodontal infections. J Periodontol 76:2075–2084. https://doi.org/10.1902/jop.2005.76.11-S.2075

    Article  PubMed  Google Scholar 

  3. Yudkin JS, Kumari M, Humphries SE, Mohamed-Ali V (2000) Inflammation, obesity, stress and coronary heart disease: is interleukin-6 the link? Atherosclerosis 148:209–214

    Article  Google Scholar 

  4. Yamaguchi N, Kukita T, Li YJ, Martinez Argueta JG, Saito T, Hanazawa S, Yamashita Y (2007) Adiponectin inhibits osteoclast formation stimulated by lipopolysaccharide from Actinobacillus actinomycetemcomitans. FEMS Immunol Med Microbiol 49:28–34

    Article  Google Scholar 

  5. Martin A, David V, Malaval L, Lafage-Proust MH, Vico L, Thomas T (2007) Opposite effects of leptin on bone metabolism: a dose-dependent balance related to energy intake and insulin-like growth factor-I pathway. Endocrinology 148:3419–3425. https://doi.org/10.1210/en.2006-1541

    Article  PubMed  Google Scholar 

  6. Shimada Y, Komatsu Y, Ikezawa-Suzuki I, Tai H, Sugita N, Yoshie H (2010) The effect of periodontal treatment on serum leptin, interleukin-6, and C-reactive protein. J Periodontol 81:1118–1123. https://doi.org/10.1902/jop.2010.090741

    Article  PubMed  Google Scholar 

  7. Gursoy UK, Marakoglu I, Ersan S (2006) Periodontal status and cytoplasmic enzyme activities in gingival crevicular fluid of type 2 diabetic and/or obese patients with chronic periodontitis. J Int Acad Periodontol 8:2–5>

    PubMed  Google Scholar 

  8. Gonçalves TE, Zimmermann GS, Figueiredo LC, Souza Mde C, da Cruz DF, Bastos MF, da Silva HD, Duarte PM (2015) Local and serum levels of adipokines in patients with obesity after periodontal therapy: one-year follow-up. J Clin Periodontol 42:431–439. https://doi.org/10.1111/jcpe.12396

    Article  PubMed  Google Scholar 

  9. Moura-Grec PG, Marsicano JA, Carvalho CA, Sales-Peres SH (2014) Obesity and periodontitis: systematic review and meta-analysis. Cien Saude Colet 19:1763–1772

    Article  Google Scholar 

  10. Khan S, Barrington G, Bettiol S, Barnett T, Crocombe L (2018) Is overweight/obesity a risk factor for periodontitis in young adults and adolescents?: a systematic review. Obes Rev 19:852–883. https://doi.org/10.1111/obr.12668

    Article  PubMed  Google Scholar 

  11. Virto L, Cano P, Jiménez-Ortega V, Fernández-Mateos P, González J, Esquifino AI, Sanz M (2018) Obesity and periodontitis: an experimental study to evaluate periodontal and systemic effects of comorbidity. J Periodontol 89:176–185

    PubMed  Google Scholar 

  12. Kinane DF (2001) Causation and pathogenesis of periodontal disease. Periodontol 25:8–20

    Article  Google Scholar 

  13. Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A (2016) Physiological changes in pregnancy. Cardiovasc J Afr 27:89–94. https://doi.org/10.5830/CVJA-2016-021

    Article  PubMed  PubMed Central  Google Scholar 

  14. Silva de Araujo Figueiredo C, Gonçalves Carvalho Rosalem C, Costa Cantanhede AL, Abreu Fonseca Thomaz ÉB, Fontoura Nogueira da Cruz MC (2017) Systemic alterations and their oral manifestations in pregnant women. J Obstet Gynaecol Res 43:16–22. https://doi.org/10.1111/jog.13150

    Article  PubMed  Google Scholar 

  15. Boggess KA, Edelstein BL (2006) Oral health in women during preconception and pregnancy: implications for birth outcomes and infant oral health. Matern Child Health J 10:S169–S174. https://doi.org/10.1007/s10995-006-0095-x

    Article  PubMed  Google Scholar 

  16. Silk H, Douglass AB, Douglass JM, Silk L (2008) Oral health during pregnancy. Am Fam Physician 77:1139–1144

    PubMed  Google Scholar 

  17. Chapper A, Munch A, Schermann C, Piacentini CC, Fasolo MT (2005) Obesity and periodontal disease in diabetic pregnant women. Braz Oral Res 19:83–87. https://doi.org/10.1590/S1806-83242005000200002

    Article  Google Scholar 

  18. Lee HJ, Jun JK, Lee SM, Ha JE, Paik DI, Bae KH (2014) Association between obesity and periodontitis in pregnant females. J Periodontol 85:e224–e231. https://doi.org/10.1902/jop.2014.130578

    Article  PubMed  Google Scholar 

  19. Piscoya MD, Ximenes RA, Silva GM, Jamelli SR, Coutinho SB (2012) Periodontitis-associated risk factors in pregnant women. Clinics (Sao Paulo) 67:27–33

    Article  Google Scholar 

  20. Vogt M, Sallum AW, Cecatti JG, Morais SS (2012) Factors associated with the prevalence of periodontal disease in low-risk pregnant women. Reprod Health 9:3. https://doi.org/10.1186/1742-4755-9-3

    Article  PubMed  PubMed Central  Google Scholar 

  21. Xie Y, Xiong X, Elkind-Hirsch KE, Pridjian G, Maney P, Delarosa RL, Buekens P (2014) Prepregnancy obesity and periodontitis among pregnant females with and without gestational diabetes mellitus. J Periodontol 85:890–898. https://doi.org/10.1902/jop.2013.130502

    Article  PubMed  Google Scholar 

  22. Zambon M, Mandò C, Lissoni A, Anelli GM, Novielli C, Cardellicchio M, Leone R, Monari MN, Massari M, Cetin I, Abati S (2018) Inflammatory and oxidative responses in pregnancies with obesity and periodontal disease. Reprod Sci 25:1474–1484. https://doi.org/10.1177/1933719117749758

    Article  PubMed  Google Scholar 

  23. Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M, STROBE Initiative (2014) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Int J Surg 12:1500–1524. https://doi.org/10.1016/j.ijsu.2014.07.014

    Article  PubMed  Google Scholar 

  24. World Health Organization (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser, 894:i–xii, 1–253

  25. Invernici MM, Salvador SL, Silva PHF, Soares MSM, Casarin R, Palioto DB, Souza SLS, Taba M Jr, Novaes AB Jr, Furlaneto FAC, Messora MR (2018) Effects of Bifidobacterium probiotic on the treatment of chronic periodontitis: a randomized clinical trial. J Clin Periodontol 45:1198–1210. https://doi.org/10.1111/jcpe.12995

    Article  PubMed  PubMed Central  Google Scholar 

  26. Page RC, Eke PI (2007) Case definitions for use in population-based surveillance of periodontitis. J Periodontol 78:1387–1399. https://doi.org/10.1902/jop.2007.060264

    Article  PubMed  Google Scholar 

  27. Ainamo J, Bay I (1975) Problems and proposals for recording gingivitis and plaque. Int Dent J 25:229–235

    PubMed  Google Scholar 

  28. Lang NP, Joss A, Orsanic T, Gusberti FA, Siegrist BE (1986) Bleeding on probing. A predictor for the progression of periodontal disease? J Clin Periodontol 13:590–596

    Article  Google Scholar 

  29. Borrell LN, Burt BA, Neighbors HW, Taylor GW (2004) Social factors and periodontitis in an older population. Am J Public Health 94:748–754

    Article  Google Scholar 

  30. Pilotto LM, Celeste RK, Faerstein E, de Slavutzky SMB (2014) Association between tooth loss and overweight/obesity among Brazilian adults: the Pro-Saude Study. Braz Oral Res 28:275–280

    Article  Google Scholar 

  31. Gao X, Yan Y, Xiang S, Zeng G, Liu S, Sha T, He Q, Li H, Tan S, Chen C, Li L, Yan Q (2017) The mutual effect of pre-pregnancy body mass index, waist circumference and gestational weight gain on obesity-related adverse pregnancy outcomes: a birth cohort study. PLoS One 12:e0177418. https://doi.org/10.1371/journal.pone.0177418

    Article  PubMed  PubMed Central  Google Scholar 

  32. Aliyu MH, Luke S, Wilson RE, Saidu R, Alio AP, Salihu HM, Belogolovkin V (2010) Obesity in older mothers, gestational weight gain, and risk estimates for preterm phenotypes. Maturitas 66:88–93. https://doi.org/10.1016/j.maturitas.2010.02.016

    Article  PubMed  Google Scholar 

  33. Li G, Huang W, Zhang L, Tian Z, Zheng W, Wang T, Zhang T, Zhang W (2018) A prospective cohort study of early-pregnancy risk factors for gestational diabetes in polycystic ovarian syndrome. Diabetes Metab Res Rev 34:e3003. https://doi.org/10.1002/dmrr.3003

    Article  PubMed  Google Scholar 

  34. Yu ZB, Han SP, Zhu JA, Sun XF, Ji CB, Guo XR (2013) Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight/obesity: a systematic review and meta-analysis. PLoS One 8:e61627. https://doi.org/10.1371/journal.pone.0061627

    Article  PubMed  PubMed Central  Google Scholar 

  35. Zilberlicht A, Feferkorn I, Younes G, Damti A, Auslender R, Riskin-Mashiah S (2016) The mutual effect of pregestational body mass index, maternal hyperglycemia and gestational weight gain on adverse pregnancy outcomes. Gynecol Endocrinol 32:416–420. https://doi.org/10.3109/09513590.2015.1127911

    Article  PubMed  Google Scholar 

  36. de Koning L, Merchant AT, Pogue J, Anand SS (2007) Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. Eur Heart J 28:850–856. https://doi.org/10.1093/eurheartj/ehm026

    Article  PubMed  Google Scholar 

  37. Leong XF, Ng CY, Badiah B, Das S (2014) Association between hypertension and periodontitis: possible mechanisms. ScientificWorldJournal 2014:768237. https://doi.org/10.1155/2014/768237

    Article  PubMed  PubMed Central  Google Scholar 

  38. Macedo Paizan ML, Vilela-Martin JF (2014) Is there an association between periodontitis and hypertension? Curr Cardiol Rev 10:355–361

    Article  Google Scholar 

  39. Zimmermann GS, Bastos MF, Dias Goncalves TE, Chambrone L, Duarte PM (2013) Local and circulating levels of adipocytokines in obese and normal weight individuals with chronic periodontitis. J Periodontol 84:624–633. https://doi.org/10.1902/jop.2012.120254

    Article  PubMed  Google Scholar 

  40. Genco RJ, Borgnakke WS (2013) Risk factors for periodontal disease. Periodontol 62:59–94. https://doi.org/10.1111/j.1600-0757.2012.00457.x.

    Article  Google Scholar 

  41. González-Jaranay M, Téllez L, Roa-López A, Gómez-Moreno G, Moreu G (2017) Periodontal status during pregnancy and postpartum. PLoS One 12:e0178234. https://doi.org/10.1371/journal.pone.0178234

    Article  PubMed  PubMed Central  Google Scholar 

  42. Saito T, Shimazaki Y, Kiyohara Y, Kato I, Kubo M, Iida M, Yamashita Y (2005) Relationship between obesity, glucose tolerance, and periodontal disease in Japanese women: the Hisayama study. J Periodontal Res 40:346–353. https://doi.org/10.1111/j.1600-0765.2005.00813.x

    Article  PubMed  Google Scholar 

  43. Dalla Vecchia CF, Susin C, CK R¨s, Oppermann RV, Albandar JM (2005) Overweight and obesity as risk indicators for periodontitis in adults. J Periodontol 76:1721–1728. https://doi.org/10.1902/jop.2005.76.10.1721

    Article  PubMed  Google Scholar 

  44. Pataro AL, Costa FO, Cortelli SC, Cortelli JR, Abreu MH, Costa JE (2012) Association between severity of body mass index and periodontal condition in women. Clin Oral Investig 16:727–734. https://doi.org/10.1007/s00784-011-0554-7

    Article  PubMed  Google Scholar 

  45. Lee HJ, Ha JE, Bae KH (2016) Synergistic effect of maternal obesity and periodontitis on preterm birth in women with pre-eclampsia: a prospective study. J Clin Periodontol 43:646–651. https://doi.org/10.1111/jcpe.12574

    Article  PubMed  Google Scholar 

  46. Ide M, Papapanou PN (2013) Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes – systematic review. J Periodontol 84:S181–S194. https://doi.org/10.1902/jop.2013.134009

    Article  PubMed  Google Scholar 

  47. López NJ, Smith PC, Gutierrez J (2002) Higher risk of preterm birth and low birth weight in women with periodontal disease. J Dent Res 81:58–63

    Article  Google Scholar 

  48. Turton M, Africa CWJ (2017) Further evidence for periodontal disease as a risk indicator for adverse pregnancy outcomes. Int Dent J 67:148–156. https://doi.org/10.1111/idj.12274

    Article  PubMed  Google Scholar 

  49. Boggess KA, Lieff S, Murtha AP, Moss K, Beck J, Offenbacher S (2003) Maternal periodontal disease is associated with an increased risk for preeclampsia. Obstet Gynecol 101:227–231

    PubMed  Google Scholar 

  50. Offenbacher S, Jared HL, O'Reilly PG, Wells SR, Salvi GE, Lawrence HP, Socransky SS, Beck JD (1998) Potential pathogenic mechanisms of periodontitis associated pregnancy complications. Ann Periodontol 3:233–250. https://doi.org/10.1902/annals.1998.3.1.233

    Article  PubMed  Google Scholar 

  51. Vergnes JN, Sixou M (2007) Preterm low birth weight and maternal periodontal status: a meta-analysis. Am J Obstet Gynecol 196:135.e1–135.e7. https://doi.org/10.1016/j.ajog.2006.09.028

    Article  Google Scholar 

  52. Udagawa S, Katagiri S, Maekawa S, Takeuchi Y, Komazaki R, Ohtsu A, Sasaki N, Shiba T, Watanabe K, Ishihara K, Sato N, Miyasaka N, Izumi Y (2018) Effect of Porphyromonas gingivalis infection in the placenta and umbilical cord in pregnant mice with low birth weight. Acta Odontol Scand 76:433–441. https://doi.org/10.1080/00016357.2018.1426876

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank the São Paulo Research Foundation (FAPESP; grant no. 2015/25421-4), CNPq (grant no. 301578/2016-8), and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES - Finance Code 001) for supporting this study.

Funding

The work was financially supported by the São Paulo Research Foundation (FAPESP; grant no. 2015/25421-4), the CNPq (grant no. 301578/2016-8), and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES - Finance Code 001).

Author information

Authors and Affiliations

  1. Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil

    Gerson Aparecido Foratori-Junior, Bruna Machado da Silva, Ana Carolina da Silva Pinto, Heitor Marque Honório & Silvia Helena de Carvalho Sales-Peres

  2. Department of Physiological Sciences, Area of Pharmacology, Piracicaba Dental School, University of Campinas, Campinas, São Paulo, Brazil

    Francisco Carlos Groppo

Authors
  1. Gerson Aparecido Foratori-Junior
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bruna Machado da Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ana Carolina da Silva Pinto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Heitor Marque Honório
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Francisco Carlos Groppo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Silvia Helena de Carvalho Sales-Peres
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Silvia Helena de Carvalho Sales-Peres.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed written consent was obtained from all individual participants included in the study.

Disclaimer

It is important to highlight, however, that FAPESP, CNPq, and CAPES had no role in the study design, data analysis, or manuscript drafting/approval.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Online Resource 1

(PDF 128 kb)

Online Resource 2

(PDF 128 kb)

Online Resource 3

(PDF 131 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Foratori-Junior, G.A., da Silva, B.M., da Silva Pinto, A.C. et al. Systemic and periodontal conditions of overweight/obese patients during pregnancy and after delivery: a prospective cohort. Clin Oral Invest 24, 157–165 (2020). https://doi.org/10.1007/s00784-019-02932-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-019-02932-x

Keywords

Search

Navigation