Role of cytokines in development of pre-eclampsia associated with periodontal disease - Cohort Study

Aim The present study was designed to find any association of cytokines in women with periodontal disease and development of pre-eclampsia in North Indian population. Materials and Methods A total of 504 consecutively registered primigravida with a single live pregnancy were recruited at 14-18weeks of gestation from antenatal clinic of Maulana Azad Medical College & associated Lok Nayak Hospital and Maulana Azad Institute of Dental Sciences, New Delhi. One periodontist performed oral health examination of all patients at inclusion into study. Blood samples were collected to measure the level of cytokines IL-4, IL-10, TNF-alpha and IFN-gamma. Results The profile of blood levels of cytokines from women with periodontal disease was observed. The log serum levels of TNF-alpha & IL-4 at 16-18weeks of gestation were significantly higher in women with periodontal disease (4.13 +/- 2.06; 0.47 +/- 1.56pg/ml respectively) than in women with healthy gums (2.16 +/- 1.51; 0.02 +/- 1.84pg/ml respectively, p<0.001). Periodontal disease is associated with log serum TNF-alpha levels at cut-off >= 14.43pg/ml at sensitivity 71.2% and specificity 62% (OR=4.04; 95%CI=2.77-5.87). Woman with periodontal disease who later developed pre-eclampsia had lower levels of TNF-alpha (3.72 +/- 1.33pg/ml) than those with periodontal disease who did not develop pre-eclampsia (4.20 +/- 2.15pg/ml, p >= 0.05). Conclusion Reduced TNF-alpha level secretion in the early second trimester in women with periodontal disease appears to be associated with the development of pre-eclampsia.