Periodontitis and plasma C-reactive protein during pregnancy

Background: Periodontitis has been associated with increased risk of adverse pregnancy outcomes and elevated C-reactive protein (CRP) concentrations in non-pregnant adults. We examined the relationship between periodontitis and CRP among women who provided dental radiographs and had blood collected during early pregnancy, excluding smokers and diabetic patients. Methods: From Project Viva, an ongoing cohort study, we measured plasma CRP in 35 subjects with periodontitis (i.e., at least one site with 3 mm of alveolar bone loss) and a random sample of 66 periodontally healthy subjects matched on age and race/ethnicity. We performed linear regression analysis with log-transformed CRP levels as the outcome. Results: The mean (SE) CRP level was 65% higher (95% confidence interval: -2%, 180%; P = 0.06) in women with periodontitis (2.46 +/- 0.52 mg/l) than in controls (1.49 +/- 0.22 mg/l), adjusting for factors related to CRP levels, including age, race/ethnicity, pre-pregnancy body mass index, alcohol intake, education, income, and gestational age at blood collection. Conclusions: These findings suggest that periodontitis may increase CRP levels in pregnancy. CRP could potentially mediate the association of periodontitis with adverse pregnancy outcomes.