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| Researching the cause of gestational diabetes are from left, Pierre Buekens, dean of the School of Public Health and Tropical Medicine; Gabriella Pridjian, chair, obstetrics and gynecology, School of Medicine; and Xiong Xu, epidemiologist. (Photo by Paula Burch-Celentano) |
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Newly pregnant women have one more item to add to their to-do list: schedule a dental checkup. Good oral health care has the potential to prevent diabetes during pregnancy, according to Tulane University researchers. Their study, published in the October issue of the American Journal of Obstetrics and Gynecology, is the first to demonstrate a link between poor oral health and diabetes during pregnancy.
According to their research, nearly one out of two women with gestational diabetes also have periodontal disease. In contrast, just over one in 10 pregnant women without gestational diabetes have periodontal disease.
Periodontal disease is a chronic infection of the gums and mouth. Gestational diabetes is an inability to process dietary sugars normally during pregnancy. Gestational diabetes puts women and their babies at increased risk of injury and illness, including preeclamsia, preterm birth, birth injury and the need for a cesarean section.
"One condition could cause or exacerbate the other," says Gabriella Pridjian, chair of the Department of Obstetrics and Gynecology at the School of Medicine. "We think that it is more likely that periodontal disease predisposes to the development of gestational diabetes. The opposite is less likely because gestational diabetes occurs for only a brief time during the pregnancy, and usually resolves or improves after delivery. If periodontal disease does put a woman at greater risk of gestational diabetes, then good dental care would be protective."
The key, says the lead author, epidemiologist Xiong Xu, is to know that periodontal disease is easily treated or prevented. Xu has previously published on the association between periodontal disease during pregnancy and preterm birth, low-birth weight and preeclampsia. He is pursuing further research in the field.
"If future studies confirm our findings, this will open the door for new intervention strategies for preventing gestational diabetes," says Xu. "Treating periodontal or gum disease before or during pregnancy may reduce the risk of gestational diabetes and the poor health outcomes associated with gestational diabetes, as well as prevent type 2 diabetes later in the mother's life."
According to Pridjian, women often have the misconception that dental care during pregnancy is dangerous to the growing fetus, so they might avoid rather than seek dental checkups. She hopes research demonstrating the possible benefit of visiting a dentist during pregnancy will help dispel that myth.
The team of researchers analyzed health data from 256 pregnant women who participated in the National Health and Nutrition Examination Study III. The results showed that 44 percent of women with gestational diabetes also had periodontal disease, compared to only 13 percent of women without gestational diabetes.
Based on their analysis, the researchers recommend that dental care during pregnancy should be considered as a way to help prevent gestational diabetes.
They also analyzed data from 4,234 women who were not pregnant at the time of the survey. Results from this analysis showed that 40 percent of the nonpregnant women with type 1 or 2 diabetes also had periodontal disease, compared to 13 percent of women nondiabetic women and 25 percent of nondiabetic women who had previous gestational diabetes.
Co-authors include Tulane epidemiologist Pierre Buekens, dean of the School of Public Health and Tropical Medicine, and LSU dental health researcher Sotirios Vastardis.
