Periodontal disease behind adverse pregnancy outcomes – a myth or a true burden?
Various elements, such as genetics, biological conditions as well as environmental, socio-economical, nutritional, and lifestyle factors, play roles in the etiopathogenesis of adverse pregnancy outcomes (APOs). Furthermore, within different ethnic populations but not in all women, periodontal disease has been associated with various APOs like pre-eclampsia, preterm birth, and low birth weight.
Besides the ascending infection route from vaginal and/or cervical area, the current evidence is leaning on the focal infection model, in which three postulated pathways (i.e., metastatic infection, injury, and inflammation) may link periodontitis to APOs. Although it is well known that periodontal pathogens can translocate from the infected periodontium to blood stream and initiate a metastatic infection in the foeto-placental unit, the specific roles of inflammatory and injury mechanisms as well as their magnitude contributing to APOs remain inconclusive.
In general, APOs establish a true public health burden by enhancing the risk for maternal and fetal mortality and morbidity. In addition, offspring may be exposed to impaired development of motor, cognitive, and psychosocial skills. Therefore, it is crucial to decrease the effect of potential risk factors and enhance general health. In dentistry, our goal is to improve health-promoting behavior and periodontal condition - not only during pregnancy but throughout women´s life-span - by preventing and treating periodontal diseases, although anti-infective therapy performed during gestation may not advance birth outcomes in women with periodontitis.
Mervi Gürsoy awarded her DDS degree by the University of Helsinki (1999), and then her PhD (2012), qualification as a specialist (2013) as well as her docentship (2017) in periodontology from the University of Turku. The title of her doctoral thesis was “Pregnancy and periodontium – A clinical, microbiological, and enzymological approach via a longitudinal study”. Subsequently, she has co-authored and reviewed various research articles relating to periodontology, oral microbiology and pregnancy. She is currently holding the university lecturer position at the University of Turku and serving as the vice-president and the EFP delegate of the Finnish Periodontal Society.