Periodontal Disease as a Possible Risk Factor for Preeclampsia: Existing Evidence and Future Insights

Preeclampsia and hypertensive disorders during pregnancy significantly affect both neonatal and maternal health outcomes. Preeclampsia is characterized by the onset of high blood pressure accompanied by proteinuria or dysfunction of another organ system occurring after 20 weeks of gestation. The exact causes of preeclampsia remain uncertain. However, chronic inflammatory oral conditions, such as periodontal disease (PD), have been proposed as a modifiable risk factor due to overlapping pathogenic mechanisms. We conducted a review of existing literature using databases including PubMed, Scopus, and Web of Science. The criteria for inclusion focused on studies involving pregnant women that provided quantitative clinical assessments of PD and/or microbiological evaluations of periodontal health. Several observational studies indicate a direct association between PD and an increased risk of preeclampsia; however, the findings are inconsistent due to variations in methodologies employed across different studies. PD impact the systemic inflammation and cause the elevation of inflammatory cytokines with following oxidative stress. Interventional trials of periodontal treatments during pregnancy were not consistent, with some demonstrating lower preeclampsia incidents and others reporting no effect. There is evidence that such a link between PD and preeclampsia may exist although etiology has not been proven. More standardized, longitudinal studies are required. If confirmed, oral health screening and intervention could be incorporated into prenatal care programs in order to reduce the risk of preeclampsia.