Parâmetros periodontais clínicos e microbiológicos de mulheres na gestação e no pós-parto

Abstract

The levels of estrogen and progesterone necessary for maintenance of pregnancy may contribute to increased susceptibility to the occurrence of certain periodontopathogenic bacteria and subsequent development of periodontal disease in pregnant women. The aim of this study was to evaluate clinical and microbiological parameters in women during pregnancy and post-partum. The findings of the pregnant women were compared with a control group of non-pregnant ones. This longitudinal study, with a cross-sectional parallel design, included 31 women at second trimester of their pregnancy, examined one time during pregnancy and twice during post-partum (48h and 8 weeks after the delivery), and 20 non-pregnant women within the same age range. Bleeding on probing (BOP), presence de calculus (PC), probing depth (PD) and clinical attachment level (CAL) were recorded. Bacterial samples from the subgingival biofilm and saliva were collected and the fluorescence in situ hybridization (FISH) technique identified the presence and number of Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Campylobacter rectus, Porphyromonas gingivalis, Treponema denticola, Fusobacterium nucleatum, Prevotella intermedia and Prevotella nigrescens. The Mann-Whitney U-test was applied to compare clinical and microbiological data from pregnant and non-pregnant women. The Friedman and Wilcoxon tests were used for intra-group comparisons. Pregnant and non-pregnant women showed similar periodontal conditions. Regarding the subgingival microbiota, no significant difference was found among women in the second trimester of pregnancy and nonpregnant women. Regarding the salivary microbiota, it was observed higher abundance of P. intermedia in pregnant compared with non-pregnant women. In intra-group comparison, for clinical parameters, Friedman test showed significant difference concerning PD = 4-5 mm, not confirmed by the Wilcoxon test. Regarding the microbiological parameters, in the subgingival biofilm it was found that numbers of P. nigrescens decreased among the three periods analyzed, increased bacterial counts were found for C. rectus from the second trimester to 48h after the delivery, as well as for P. intermedia from 48h to 8 weeks post-partum. In saliva, there was a significant reduction of P. intermedia and P. nigrescens among the longitudinal follow-up, with the highest values found in the second trimester of pregnancy. In 10 conclusion, the results confirm the hypothesis that there is a change in the microbiota during pregnancy, at least for P. nigrescens, P. intermedia and C. rectus, although little difference was observed in relation to clinical parameters.