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PhD ceremony Ms. A. Kunnen: Periodontitis & preeclampsia

When:We 09-10-2013 at 14:30

PhD ceremony: Ms. A. Kunnen, 14.30 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Periodontitis & preeclampsia

Promotor(s): prof. F. Abbas, prof. J.G. Aarnoudse, prof. C.P. van der Schans

Faculty: Medical Sciences

There are strong indications that periodontitis is involved in pregnancy complications, such as preterm birth and low birth weight. This thesis shows that periodontitis is also associated with preeclampsia. This association is most evident in early-onset preeclampsia (<34 weeks of gestation). This thesis also shows that one of the most important periodontopathic micro-organisms, Porphyromonas gingivalis, appears to play a role in the development of maternal hypertension, placental and foetal growth restriction and miscarriage in a rat experiment. It is unlikely, however, that periodontitis plays a causal role in the pathogenesis of preeclampsia, because the pro-inflammatory lipopolysaccharide of P. gingivalis did not induce proteinuria or a generalised systemic inflammatory response in the pregnant rat. Moreover, P. gingivalis did not induce pro-inflammatory cytokine production in blood of pregnant and non-pregnant women in in vitro and ex vivo experiments. Periodontal therapy performed at about 20 weeks of gestation does not lead to a reduction in preeclamptic pregnancies. However, it is possible that periodontal treatment performed at about 20 weeks of gestation is too late in pregnancy to prevent preeclampsia, because periodontal pathogens may enter the maternal blood stream and reach the placenta early in pregnancy. Further research on treatment earlier in pregnancy, or perhaps even before conception, is recommended. Irrespective of an aetiological role of periodontitis in pregnancy complications, the state of pregnancy increases the susceptibility to periodontal infections. Therefore, early detection and treatment of periodontitis prior to or during pregnancy remain unquestionably of benefit to the mother and should be performed at all time.

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