Immune Markers Linking Chronic Periodontitis with Gestational Complications: A Systematic Review

Area of Science:

• Periodontology
• Obstetrics
• Immunology

Background:

• Chronic periodontitis is a prevalent oral infection.
• Adverse pregnancy outcomes (APOs) pose significant risks to maternal and fetal health.
• The link between periodontitis and APOs is increasingly recognized.

Purpose of the Study:

• To systematically review the causal associations between chronic periodontitis and APOs.
• To identify the specific inflammatory mediators involved in this relationship.
• To understand the mechanisms linking periodontitis to pregnancy complications.

Main Methods:

• Systematic review following PRISMA 2020 guidelines.
• PECO model for study selection focusing on inflammatory mediators.
• Searched six major databases for English-language studies (2000-2025).
• Qualitative synthesis of findings with risk of bias assessment.

Main Results:

• Chronic periodontitis is strongly associated with APOs, including gestational diabetes mellitus (GDM), preterm delivery, preeclampsia, and low birth weight (LBW).
• Elevated inflammatory mediators such as TNF-α, IL-1β, IL-6, IL-8, CRP, PGE2, MCP-1, and MMPs are implicated.
• These mediators disrupt placental function, impacting fetal development.

Conclusions:

• Periodontitis contributes to APOs via direct microbial invasion and systemic inflammation.
• Mediators disrupt placental function and fetal development.
• Maintaining periodontal health is vital for preventing pregnancy complications like GDM, preeclampsia, preterm delivery, and LBW.