Gingival changes during pregnancy: I. Influence of hormonal variations on clinical and immunological parameters

Aim: To test whether exacerbated gingival inflammation in pregnancy is associated with increased salivary hormone levels and changes in gingival crevicular fluid (GCF) interleukin-1 beta (IL-1 beta) and prostaglandin-E2 (PGE2) levels. Material and methods: In this cohort study, 48 pregnant women without periodontitis were evaluated in the first, second, and third trimesters and at 3 months postpartum. Twenty-eight non-periodontitis non-pregnant women were evaluated twice, with a 6-month interval. Plaque and gingival indices (PlI, GI), salivary progesterone and estradiol and GCF IL-1 beta and PGE2 levels were determined. ANOVA for repeated measures or Friedman's test were used for intragroup analyses. Inter-group comparisons were analysed with t-test or Mann-Whitney U-test. Correlations were evaluated with Pearson's and Spearman's test. Results: Pregnant women showed an increase in GI (p < 0.05) despite maintaining low PlI values. No changes in IL-1 beta and PGE2 levels were observed during pregnancy. No significant correlation was found between the GI increase and salivary hormone levels. GI (p < 0.05) and IL-1 beta levels (p < 0.001) were lower in non-pregnant than in pregnant women. Conclusion: This study confirms the presence of an exacerbated gingival inflammation during pregnancy, but this phenomenon could not be associated with an increase in progesterone or estradiol or with changes in PGE2 or IL-1 beta.