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Periodontal disease severity is related to high levels of C-reactive protein in pre-eclampsia

Herrera, Julián Aa; Parra, Beatrizb; Herrera, Enriquec; Botero, Javier Ed; Arce, Roger Md; Contreras, Adolfoe; López-Jaramillo, Patriciof

doi: 10.1097/HJH.0b013e3281139ea9
Original papers: Pre-eclampsia

Objective Recent studies have shown that pre-eclamptic women present a high prevalence of periodontitis, suggesting that active periodontal disease may play a role in the pathogenesis of pre-eclampsia. The present study analysed the effect of periodontal disease in the concentrations of serum high-sensitivity C-reactive protein (hs-CRP), and its association with pre-eclampsia.

Methods A case–control study was carried out in Cali-Colombia, comprised of 398 pregnant women (145 cases and 253 controls) who were believed to have periodontal disease, between 28 and 36 weeks of gestational age. Pre-eclampsia cases were defined as blood pressure ≥ 140/90 mmHg and proteinuria ≥ 0.3 g/24 h. Controls were pregnant women with normal blood pressure, without proteinuria, matched by maternal age, gestational age and body mass index. Sociodemographic data, obstetric risk factors, periodontal state, subgingival microbial composition and hs-CRP levels were determined in both groups.

Results The case and control groups were comparable for sociodemographic characteristics. In women with pre-eclampsia and confirmed periodontal disease (n = 138), hs-CRP levels increased according to the severity of the disease (gingivitis median 4.14 mg/dl; mild periodontitis median 4.70 mg/dl; moderate/severe periodontitis median 8.8 mg/dl; P = 0.01). A similar tendency was observed in controls with periodontal disease (n = 251), but it did not reach statistical significance (gingivitis median 5.10 mg/dl; mild periodontitis median 5.12 mg/dl; moderate/severe periodontitis median 6.90 mg/dl; P = 0.07). A significant difference in hs-CRP levels was observed in pre-eclamptic women with moderate/severe periodontitis compared to controls (P = 0.01).

Conclusion These findings suggest that chronic periodontitis may increase hs-CRP levels in pregnant women and lead to complications such as pre-eclampsia.

aDepartment of Family Medicine, School of Medicine, Universidad del Valle, Cali

bEmerging Diseases Research Group, School of Microbiology, Universidad del Valle, Cali

cDepartment of Obstetrics and Gynaecology, School of Medicine, Universidad del Valle, Cali

dSchool of Dentistry, Periodontal Medicine Research Group, Universidad del Valle, Cali

eSchool of Dentistry, Universidad del Valle, San Fernando

fFundación Cardiovascular de Colombia and Medical School, Universidad de Santander, Bucaramanga-Colombia, Colombia

Received 24 March, 2006

Revised 28 December, 2006

Accepted 15 February, 2007

Correspondence to Dr Julián A. Herrera, School of Medicine, University of Valle at Cali-Colombia, Calle 4B 36-00 San Fernando, Cali, Colombia Tel:/fax: +57 2556 5621; e-mail:

© 2007 Lippincott Williams & Wilkins, Inc.