Comparative Evaluation of C-reactive Protein In Pregnant Women with or Without Periodontitis: A Randomized Control Trial
Comparative Evaluation of C-reactive Protein In Pregnant Women with or Without Periodontitis: A Randomized Control Trial
Keywords:
plaque biofilm, inflammatory mediators, C- reactive protein, periodontitis, Pregnant women.
Abstract
Background: Serum C-reactive protein (CRP) is non-specific in nature and is seen to be associated with adverse pregnancy outcomes. Thus we aim to compare serum CRP levels in pregnant women with and without periodontitis.
Methods: A total of 222 pregnant women aged between 18-45 years were recruited in study and divided into two groups Group A:- Pregnant patient without periodontitis (n=100) and Group B:- Pregnant patient with periodontitis (n=122). Different clinical parameters such as plaque index (PI), gingival index (GI), probing depth (PD) and clinical attachment loss (CAL) were evaluated. A 2 ml of blood sample was taken from antecubital vein for quantative serum CRP analysis.
Results: The mean CRP level in Group B was found to be higher (4.22 + 2.247 mg/L) than Group A (1.55 + 0.702 mg/L). In both the groups, statistically significant and positive correlation of PI with GI and CRP level was found (p < 0.05). Similarly, in Group B, PI showed a positive correlation with PD & CAL whereas, PD showed a similar correlation with CAL & CRP level was statistically significant. (p < 0.05).
Conclusion: Periodontitis influenced the serum CRP levels in pregnant patients representing increased inflammatory burden.
References
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(30) Bolla V, Kumari PS, Munnangi SR, Kumar DS, Durgabai Y, Koppolu P. Evaluation of serum c‑reactive protein levels in subjects with aggressive and chronic periodontitis in comparison with healthy controls: A clinico‑biochemical study. Int J App Basic Med Res 2017; 7: 121-4.
(31) Bansal T, Dhruvakumar D, Pandey A. Comparative evaluation of C-reactive protein in peripheral blood of patients with healthy gingiva, gingivitis and chronic periodontitis: A clinical and particle-enhanced tubidimetric immuno- analysis. J Indian Soc Periodontol 2014; 18: 739-43.
(32) Goyal L, Bey A, Gupta ND, Sharma VK. Comparative evaluation of serum C-reactive protein levels in chronic and aggressive periodontitis patient and association with periodontal disease severity. Contemp Clin Dent 2014; 5: 484-8.
(33) Chopra R, Patil SR, Mathur S. Comparison of cardio vesicular disease risk in two main forms of periodontitis. Dent Res J (Isfahan) 2012; 9: 74-9.
(34) Usin MM, Tabares SM, Parodi RJ, andSembaj A. Periodontal conditions during the pregnancy associated with periodontal pathogens. J Investig Clin Dent 2013; 4: 54-9. doi: 10.1111/j.2041-1626.2012.00137.
(35) Belo L, Silva AS, Rocha S, Caslake M, Cooney J, Leite LP et al. Fluctuations in Creactive protein concentration and neutrophil activation during normal human pregnancy. Eur J of Obstet & Gynecol Reprod Biol 2005; 123: 46-51.
(36) Radafshar G, Shad B, Mirfeizi M. Association between periodontal disease and elevated C reactive protein in acute myocardial infarction patients. J Dent Tehran Uni Med Sci 2006; 3: 129–35.
(2) Akira S, Takeda K. Toll like receptor signaling. Nat Rev Immunol 2004; 4: 499-511.
(3) Page RC. The role of inflammatory mediators in pathogenesis of periodontal disease. J Periodontal Res 1991; 26: 230-42
(4) Moshage H. Cytokines and acute phase response. J Pathol 1997; 181: 257-66.
(5) Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Perioodontol 1996; 67: 1103-13.
(6) Lopez NJ, Smith PC, Gutierrez J. Higher risk of preterm birth and low birth weight in woman with periodontal disease. J Dent Res 2002; 81: 58-63.
(7) Scannapieco FA, Bush RB, Paju S. Periodontal disease as a risk factor for adverse pregnancy outcome. A systemic review. Ann Periodontol 2003; 8: 70-8.
(8) Otomo-Corgel J and Steinberg BJ. Periodontal medicine and the female patient. In: Rose LF, Genco RJ, Mealey BL, Cohen DW. Periodontal medicine, 1st edition: London; B.C. Decker Inc; 2000.p.151-65.
(9) Ernst GDS, de Jonge LL, Hofman A et al. C-reactive protein levels in early pregnancy, fetal growth patterns, and the risk for neonatal complications: The generation R study. Am J Obstet Gynecol 2011; 205: 132.e1-8.
(10) Graziani F, Cei S, Tonetti M, Paolantonio M, Serio R, Sammartino G et al. Systemic inflammation following non-surgical and surgical periodontal therapy. J Clin Periodontol 2010; 37: 848-52.
(11) Tillet WS, Francis T. Serological reaction in pneumonia with a non-protein somatic fraction of the pneumococcus. J Exp Med 1930; 52: 561-71
(12) Terana E, Escuderob C, Moyab W, Floresb M, Vallancec P, Jaramillob PL. Elevated Creactive protein and pro-inflammatory cytokines in andean women with pre-eclampsia. Int J Gynecol & Obstet 2001; 75: 243-9.
(13) Toja ML, van Vugt JM, Go AT, Blankenstein MA, Oudejans CB,van Wijk IJ. Elevated c reactive protein levels during first trimester of pregnancy are indicative of preeclampsia and intrauterine growth restriction. J Reprod Immunol 2003; 59: 29-37.
(14) Pitiphat W, Gillman MW, Joshipura KJ, Williams PL, Douglass CW, and Rich-Edwards JW Plasma C-reactive protein in early pregnancy and preterm delivery. Am J Epidemiol 2005; 162: 1108-113.
(15) Slade GD, Offenbacher S, Beck JD, Heiss G, Pancow JS. Acute phase inflammatory response to periodontal disease in the US population. J Dent Res 2000; 79: 49-50.
(16) Noack B, Genco RJ, Trevisan M, Grossi S, Zambon JJ, Nardin ED. Periodontal infections contribute to elevated systemic C-reactive protein level. J Periodontol 2001; 72: 1221-7.
(17) Salzberg TN, Overstreet BT, Rogers JD, Califano JV, Best AM, and Schenkein HA. Creactive protein levels in patients with aggressive periodontitis. J Periodontol 2006; 77: 933-39.
(18) Paraskevas S, Huizinga JD, Loos BG. A systematic review and meta-analyses on Creactive protein in relation to periodontitis. J Clin Periodontol 2008; 35: 277-90.
(19) Slade GD, Ghezzi EM, Heiss G, Beck JD, Riche E, Offenbacher S. Relationship between periodontal disease and C reactive protein among adults in the atherosclerosis risk in communities study. Arch Intern Med 2003; 163:1172-9.
(20) Persson GR, Pettersson T, Ohisson O, Renvert S. High sensitivity C reactive protein levels in subjects with or without myocardial infarction or periodontitis. J Clin Periodontol 2005; 32: 219-24
(21) Pitiphat W, Joshipura KJ, Rich-Edwards JW, Williams PL, Douglass CW, and Gillmani MW. Periodontitis and plasma C-reactive protein during pregnancy. J Periodontol 2006; 77: 821-25.
(22) Horton AL, Boggess KA, Moss KL, Jared HL, Beck J and Offenbacher S. Periodontal disease early in pregnancy is associated with maternal systemic inflammation among African-American women. J Periodontol 2008; 79: 1127-32.
(23) Sharma A, Ramesh A, Thomas B. Evaluation of plasma C-reactive protein levels in pregnant women with and without periodontal disease: A comparative study J Indian Soc Periodontol 2009; 13: 145-49.
(24) Mannava P, Gokhale S, Pujari S, Biswas KP, Kaliappan S, V Shashank. Comparative evaluation of Crreactive protein in pregnanat women with and without periodontal pathologies. A prospective cohort analysis. J Contemp Dent 2016; 17: 480-3.
(25) Lopez N J, Smith P C, Gutierrez J. Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: A randomized control trial. J periodontal 2002; 73: 911-24.
(26) Chandy S, Joseph K, Sankaranarayanan A, Babu G, Wilson B, Josep J. Evaluation of Creactive protein and fibrinogen in patients with chronic and aggressive periodontitis: A clinico-biochemical study. J Clin Diagn Res 2017; 11; ZC41-45
(27) Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med 1999; 340: 448-54.
(28) Sacks GP, Seyani L, Lavery S, Trew G. Maternal c reactive protein levels are raised at four week gestation. Hum Reprod 2004; 19: 1025-30.
(29) Romem Y, Artal R. C reactive protein in pregnancy and in post-partum period. Am J Obstet Gynecol 1985; 151: 380-83
(30) Bolla V, Kumari PS, Munnangi SR, Kumar DS, Durgabai Y, Koppolu P. Evaluation of serum c‑reactive protein levels in subjects with aggressive and chronic periodontitis in comparison with healthy controls: A clinico‑biochemical study. Int J App Basic Med Res 2017; 7: 121-4.
(31) Bansal T, Dhruvakumar D, Pandey A. Comparative evaluation of C-reactive protein in peripheral blood of patients with healthy gingiva, gingivitis and chronic periodontitis: A clinical and particle-enhanced tubidimetric immuno- analysis. J Indian Soc Periodontol 2014; 18: 739-43.
(32) Goyal L, Bey A, Gupta ND, Sharma VK. Comparative evaluation of serum C-reactive protein levels in chronic and aggressive periodontitis patient and association with periodontal disease severity. Contemp Clin Dent 2014; 5: 484-8.
(33) Chopra R, Patil SR, Mathur S. Comparison of cardio vesicular disease risk in two main forms of periodontitis. Dent Res J (Isfahan) 2012; 9: 74-9.
(34) Usin MM, Tabares SM, Parodi RJ, andSembaj A. Periodontal conditions during the pregnancy associated with periodontal pathogens. J Investig Clin Dent 2013; 4: 54-9. doi: 10.1111/j.2041-1626.2012.00137.
(35) Belo L, Silva AS, Rocha S, Caslake M, Cooney J, Leite LP et al. Fluctuations in Creactive protein concentration and neutrophil activation during normal human pregnancy. Eur J of Obstet & Gynecol Reprod Biol 2005; 123: 46-51.
(36) Radafshar G, Shad B, Mirfeizi M. Association between periodontal disease and elevated C reactive protein in acute myocardial infarction patients. J Dent Tehran Uni Med Sci 2006; 3: 129–35.
Published
2022-08-30
How to Cite
Garg, K. (2022). Comparative Evaluation of C-reactive Protein In Pregnant Women with or Without Periodontitis: A Randomized Control Trial . UNIVERSITY JOURNAL OF DENTAL SCIENCES, 8(4). https://doi.org/10.21276//ujds.2022.8.4.4
Section
Original Research Paper
