The Health Implications of Gum Disease On You and Your Unborn Child

Gum disease is now linked to pregnancy-related complications. Find out how maintaining good dental health can help ensure a safe pregnancy and a healthy baby.

 

The Health implications of gum disease on you and your unborn child

Photo from Flickr by Kristin Banks.

Pregnancy is a rewarding and exciting experience for many women. Not only is it a great time to take advantage of eating for two, but it is also a highly motivating time to focus on health. The tiny baby growing inside you depends on you for good health and well-being. As you begin your prenatal doctor appointments, your focus on health should also include dental health.

You are likely aware of a number of pregnancy-related concerns already, such as the risks of vitamin and mineral deficiencies, mental health conditions, high blood pressure, anemia, urinary tract infections, alcohol consumption, and smoking. But did you know that there is also a risk associated with gum disease?

Researchers have discovered a correlation between gum disease and pregnancy-related complications. It seems that gum inflammation and the bacteria in the mouth can lead to issues with pregnancy and the unborn child.

Periodontal (or gum) disease, if left untreated, can lead to a number of complications including premature birth, low birth weight, and even preeclampsia.

Let's take a closer look…

Premature Birth

According to researchers, pregnant women who develop gum disease between weeks 21 and 24 are four to seven times more likely to give birth before week 37.

Premature birth is a birth that occurs before week 37. The main concern with premature birth is that the baby's lungs have not had enough time to develop. Most babies have mature lungs by week 36, however, each baby develops at different rates. If early labor is suspected, the doctor can perform an amniocentesis which is used to check the maturity level of the lungs. If necessary, the baby can be given an injection of steroids before delivery to help speed the development of the lungs.

According to the American Pregnancy Association, lungs that have not fully matured may put the baby at risk for complications including:

Respiratory Distress Syndrome (RDS)

Respiratory distress syndrome is caused by a pulmonary surfactant deficiency in the lungs. This slippery agent helps prevent lung collapse, and when there is a deficiency, it causes harsh, irregular breathing and difficulties. Treatment may include supplemental oxygen, use of a respirator, continuous positive airway pressure, endotracheal intubation, and in severe cases, doses of surfactant.

Transient Tachypnea

Transient tachypnea is rapid shallow breathing and can occur in both premature babies and full-term babies. Treatment typically only involves altered feedings and, if necessary, intravenous feedings. The recovery time is usually three days or less.

Bronchopulmonary Dysplasia (BPD)  

Premature babies who have been on a respirator for more than twenty-eight days are at risk of developing bronchopulmonary dysplasia, a condition that occurs when there is evidence of deterioration in a baby's lungs.

Pneumonia

Pneumonia is an infection in the lungs, specifically in the area where the exchange of carbon dioxide and oxygen occurs. The infection causes inflammation, reducing the amount of space available for the air exchange and reducing the amount of oxygen for the baby. Antibiotics, supplemental oxygen, and intubation may be given. If it goes untreated, pneumonia can be fatal or lead to sepsis or meningitis.

Apnea and Bradycardia

Apnea is the absence of breathing and bradycardia is a reduction of heart rate. In the NICU, babies are monitored and an alarm will sound if a newborn develops an irregular breathing pattern of pauses longer than 10 to 15 seconds and when the heart rate falls below 100 beats per minute. Treatment usually only requires a little tap or simple rub on the back.

Infection

A premature baby may not have a strong enough immune system to resist certain infections and is placed in an incubator for protection against infections.

Jaundice

Jaundice is a common, usually harmless, condition in newborns, especially preemies. It is caused by the buildup of bilirubin, a yellow pigment produced during normal breakdown of red blood cells, in the blood. Symptoms may include yellowing of the eyes and skin, fever, ill appearance, and poor feeding. Treatment may include phototherapy and may take one week to ten days.

Intraventricular Hemorrhage (IVH)

Intraventricular hemorrhage, or IVH, is a serious condition that involves bleeding in the brain. This happens when a baby's immature blood vessels are unable to tolerate changes in circulation that took place during labor. The risk for intracranial hemorrhage increases for babies born prior to week 34 and occurs in about 33% of babies born at 24 to 26 weeks.

Future complications from IVH can include cerebral palsy, mental retardation, and learning difficulties. Fortunately, if the need for early labor is identified, there are medications the mother can take to reduce the risk of severe intracranial hemorrhage in the newborn.  

Inability to Maintain Body Heat

When a baby is born prematurely, he has a hard time maintaining body heat because he has little body fat and immature skin. Treatment involves incubation.

Immature Gastrointestinal and Digestive System

Another issue with premature birth is that the gastrointestinal systems are under-developed and unable to absorb nutrients effectively. Treatment usually includes intravenous feedings and feedings through a tube.

Anemia

Anemia is a medical condition caused by abnormally low concentrations of red blood cells which are important for carrying hemoglobin that carries oxygen through the bloodstream. A healthy level of red blood cells is higher than 15 grams. Premature babies have a greater risk of having low levels of red blood cells. In severe cases, anemia can be treated with a transfusion of red blood cells.

Patent Ductus Arteriosus (PDA)

PDA is a cardiac disorder and it causes difficulties in breathing after delivery. A chemical compound called prostaglandin E is responsible for circulating the baby's blood and keeping the ductus arteriosus open so that blood can be diverted from the lungs into the aorta. In full-term babies, the levels of this chemical drops, allowing the ductus arteriosus to close. This allows the lungs to receive the blood necessary for proper function after birth. With a premature birth, however, the level of prostaglandin E may remain constant, causing the ductus arteriosus to stay open even after birth. Fortunately, a medication can stop or slow the production of this chemical.  

Retinopathy of Prematurity (ROP)

Sometimes in early births between weeks 24 to 26, retinopathy of prematurity, a potentially blinding eye disorder, can occur. While it can occur beyond weeks 33 to 34, it is rare for it to occur this late in gestation. ROP has many different stages and treatment will greatly depend on its severity. Laser surgery or cryosurgery are two treatment options.

Necrotizing Enterocolitis (NEC)

Necrotizing enterocolitis is a condition that occurs when a portion of the baby's intestine develops poor blood blow, and can cause an infection in the bowel wall. Treatment may include intravenous feedings and antibiotics, and operation may be necessary in severe cases.

Sepsis

Sepsis is a medical condition where bacteria enter the bloodstream and it often leads to infection in the lungs, resulting in pneumonia. Antibiotics are the typical treatment.

Premature birth is a serious concern. Taking special measures to increase the likelihood of carrying a child to full-term not only protects the baby in the short-term, but it also helps lower the risk of developing serious complications, such as heart issues, later in his life.

Low Birth Weight

Babies who are born prematurely are at risk of having a low birth weight. Everyone knows the recommended length for a pregnancy is 40 weeks, but the implications of an early birth, even by a few weeks, are not as well known. Complications associated with low birth weight include low oxygen levels at birth, inability to maintain body temperature, difficulty feeding and gaining weight, infections, breathing problems (i.e., RDS), neurologic problems (i.e., IVH), gastrointestinal problems (i.e., NEC), and sudden infant death syndrome (SIDS).

Preeclampsia

Preeclampsia is a serious pregnancy complication characterized by high blood pressure and signs of damage to another organ system, usually the kidneys, in the mother. It is a serious concern because it can affect both the mother and the baby and proper treatment typically involves early birth. According to the Mayo Clinic, it typically doesn't occur until after week 20; it can, however, occur any time during pregnancy and even up to six weeks after birth. And even a slight rise in blood pressure may be a sign of preeclampsia.

Incidentally, recent studies suggest that there may be a link between gum disease and preeclampsia, and if left untreated, it can lead to serious, even fatal, complications for both the mother and the baby. Experts say that delivery is the only cure.

The exact cause of preeclampsia is unknown, but researchers believe that damage to the lining of the blood vessels triggers the abnormal functions and symptoms that develop in preeclampsia. How does this damage occur? When substances called prostaglandins are released, they constrict and dilate the blood vessels. These are a group of lipids that are made at sites of tissue damage or infection and are involved in dealing with injury and illness. They also control processes such as inflammation, blood flow, the formation of blood clots, and the induction of labor.

Preeclampsia puts the mother at an increased risk of seizures, placental abruption, stroke, and possibly severe bleeding until the blood pressure decreases.

The doctor may recommend that the mother stays on bed rest for the remainder of the pregnancy to avoid any preventable elevation of blood pressure. Unfortunately, research, however, has not shown a benefit from bed rest and even suggests that bed rest increases the risk of developing blood clots. A conversation with a physician is recommended to ensure that this treatment method is safe for both mother and baby.

The doctor may also increase the frequency of prenatal visits, as well as blood tests, ultrasounds, and non-stress tests, as well as prescribe medications to manage the preeclampsia. Possible medications may be antihypertensives, medications used to lower dangerously high blood pressure; corticosteroids, medications that can help improve liver and platelet function and prolong the pregnancy; and anticonvulsants, medications such as magnesium sulfate used in severe cases of preeclampsia to prevent a first seizure.

But when faced with a diagnosis too early in pregnancy, it can be a very stressful time. According to the National Institutes of Health, the only cure for preeclampsia that occurs during pregnancy is for the baby to be delivered.

The best course of action during pregnancy is to begin prenatal care and continue with regular prenatal visits. Your doctor may recommend preventive measures such as evaluation of your blood pressure, kidney function, liver function, and blood clotting. Weight and blood sugar management may also reduce your risk for preeclampsia.

There is no doubt that the bacteria in the mouth is a powerful agent in contributing to all kinds of health issues. Since gum disease is now linked to pregnancy-related complications, practicing good dental hygiene while pregnant should be a top priority. Not only does it help you support your overall health, but it also helps ensure a safe pregnancy and a healthy baby.

Resources:

http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregcomplications.htm

https://www.perio.org/consumer/AAP_EFP_Pregnancy

http://www.healthline.com/health/pregnancy/preeclampsia-prevention

http://www.acog.org/Patients/FAQs/Preeclampsia-and-High-Blood-Pressure-During-Pregnancy

http://www.emedicinehealth.com/newborn_jaundice/page2_em.htm

http://americanpregnancy.org/labor-and-birth/premature-birth-complications/

http://www.sciencedaily.com/releases/2011/06/110615171408.htm

http://www.childrenshospital.org/conditions-and-treatments/conditions/low-birthweight-in-newborns/symptoms-and-causes

 

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