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The association between Porphyromonas gingivalis-specific maternal serum IgG and low birth weight
A P Dasanayake1, D Boyd, P N Madianos
1Department of Oral Biology, University of Alabama at Birmingham School of Dentistry, 35294, USA. ananda@uab.edu
Insights
Maternal antibodies to Porphyromonas gingivalis (P.g.) were linked to low birth weight (LBW) in a study of pregnant women. Higher P.g. IgG levels increased the odds of delivering LBW infants, suggesting a potential modifiable risk factor.
Area of Science:
- Obstetrics and Gynecology
- Periodontology
- Maternal-Fetal Medicine
Background:
- Low birth weight (LBW) is a significant predictor of infant mortality in Alabama.
- LBW rates are disproportionately higher among African Americans but have increased across racial groups.
- Previous research suggests poor maternal periodontal health may be an independent risk factor for LBW.
Purpose of the Study:
- To investigate the association between maternal serum antibody levels against periodontal pathogens and the risk of delivering LBW infants.
- To identify specific periodontal pathogens that may be modifiable risk factors for LBW.
Main Methods:
- A cohort of 448 pregnant women was followed from the second trimester.
- Maternal serum IgG levels against periodontal pathogens were measured in 17 LBW cases and 63 controls.
- Statistical analysis controlled for known LBW risk factors like smoking, age, and race.
Main Results:
- Significantly higher maternal serum IgG levels against Porphyromonas gingivalis (P.g.) were observed in the LBW group compared to the normal birth weight (NBW) group.
- Elevated P.g.-specific IgG levels were associated with a 4.1-fold increased odds of delivering an LBW infant.
- The association remained statistically significant after adjusting for potential confounders.
Conclusions:
- Maternal mid-trimester serum antibody levels against P. gingivalis are associated with an increased risk of low birth weight delivery.
- P. gingivalis may represent a target for interventions aimed at reducing LBW rates.
Background:
In Alabama, low birth weight (LBW) infants are about 20 times more likely to die before their first birthday compared to normal birth weight infants. While the rate of LBW has been consistently higher among African Americans compared to whites, there has been a gradual increase in LBW for both African Americans and whites over the last 15 years. In an attempt to identify modifiable risk factors for LBW, we have previously reported that a pregnant woman's poor periodontal health may be an independent risk factor for low birth weight.
Methods:
A predominantly African American and socioeconomically homogeneous group of 448 women was followed from the second trimester of their first pregnancy. Thirty-nine LBW cases were observed at the end of follow-up. Using 17 preterm LBW cases and 63 randomly selected controls from the above cohort, the periodontal pathogen-specific maternal serum IgG levels during the second trimester of pregnancy were evaluated in relation to birth weight of the infant, while controlling for known risk factors for LBW.
Results:
Porphyromonas gingivalis (P.g.)-specific maternal serum IgG levels were higher in the LBW group (mean 58.05, SE = 20.00 microg/ml) compared to the normal birth weight (NBW) group (mean 13.45, SE = 3.92 microg/ml; P= 0.004). Women with higher levels of P.g.-specific IgG had higher odds of giving birth to LBW infants (odds ratio [OR] = 4.1; 95% confidence interval [CI] for odds ratio = 1.3 to 12.8). This association remained significant after controlling for smoking, age, IgG levels against other selected periodontal pathogens, and race.
Conclusions:
Low birth weight deliveries were associated with a higher maternal serum antibody level against P. gingivalis at mid-trimester.