Smoking during pregnancy: periodontal disease increases the risk of premature birth

Smoking during pregnancy increases the risk of premature birth or birth of a baby of low birth weight, periodontal disease aggravating the effects of this addiction, reported three hospital doctors at a conference held in Bordeaux on theme "Women and tobacco."

Periodontal diseases are mixed infectious diseases of bacterial origin that are expressed by gingival inflammation more or less important (gingivitis) with or without destruction of the bone supporting the teeth (periodontitis).

It is now widely accepted that these periodontal diseases carried by mothers may lead to premature birth or low birth weight babies. According to various studies, 18% of preterm births are due to periodontitis in the mother. However, tobacco is considered the main risk factor for periodontal.

Tobacco "is likely to increase by a factor of about 5 initial risk of periodontitis, this risk is dependent on the amount of tobacco consumed and the age of the addictive behavior," noted the stakeholders, Dr. Boutigny Hervé François Boschin Elizabeth Delcourt-Debruyne (CHU Lille).

Periodontal diseases are infections of Gram-negative bacteria whose biochemical events are the local increase, that is to say, the level of periodontal rate of pro-inflammatory prostaglandins and cytokines and systemic increase of some mediators inflammation.

Cotinine (metabolite of nicotine) may potentiate the effects of certain toxins periodontal bacteria which could partly explain one of the mechanisms by which smoking increases the severity and progression of periodontitis.

In pregnant women, research suggests that bacteria from the mouth present in periodontal pockets as Fusobacterium nucleatum may, by blood, to colonize the amniotic fluid because this bacterium is found in cultured amniotic fluid in women premature labor without rupture of membranes.

A second mechanism would be an indirect way through the mediators of inflammation products contain periodontal infection.

In summary, beyond the well-known general effects that are cancerous diseases, cardiovascular and respiratory diseases, the effects of smoking during pregnancy are risk of developing periodontitis or aggravation.

Moreover, this periodontitis as that infection can lead to the onset of premature labor and even more so that tobacco is an important co-factor. Mediators of inflammation then appear to play a key role in these potential interactions.

In 1995, one in four pregnant women still smoke during the third trimester of pregnancy, say the authors.