Inflammatory and Oxidative Responses in Pregnancies With Obesity and Periodontal Disease

Reprod Sci. 2018 Oct;25(10):1474-1484. doi: 10.1177/1933719117749758. Epub 2018 Jan 17.


Background: Maternal obesity is related to immunologic and inflammatory systemic modifications that may worsen the pregnancy inflammatory status. Hormonal changes during pregnancy can adversely affect oral biofilms and oral health initiating or worsening periodontal diseases, with enhanced local and systemic oxidative stress and inflammation.

Objective: The aim of this study was to examine the relationship between local salivary and systemic parameters of oxidative stress and inflammation in relation to obesity and periodontal diseases.

Study design: Sixty-two women with singleton pregnancies were enrolled. Twenty-seven women were normal weight (NW; 18.5< body mass index [BMI] <25 kg/m2) and 35 obese (BMI ≥30 kg/m2). Seventeen of the obese had gestational diabetes mellitus (GDM). During third trimester, periodontal status was evaluated, saliva (s) was collected to assess total antioxidant capacity (s-TAC) and C-reactive protein (s-CRP) levels, and venous plasma (p) was used to measure CRP levels (p-CRP). Maternal, fetal, and placental data were registered at delivery.

Results: Levels of s-TAC, s-CRP, and p-CRP were significantly higher in obese, particularly in the presence of GDM, compared to NW and related to each other ( P = .000; r > 0.59), to maternal BMI ( P = .000; r > 0.52), and fasting glycemia ( P < .002; r > 0.47). Periodontal disease was more frequent in obese groups (80%) versus NW (52%; P = .04), particularly when GDM was diagnosed ( P = .009). A significant interaction effect between maternal BMI and oral condition was found for s-TAC levels. Obese with periodontitis showed significant increase in local and systemic parameters versus NW.

Conclusion: Obesity and periodontal disease could synergistically amplify the inflammatory and oxidative status, resulting in increased local and systemic biomarkers particularly when GDM is diagnosed.

Keywords: gestational diabetes mellitus; inflammation; obesity; oxidative stress; periodontal disease.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / metabolism
  • C-Reactive Protein / metabolism
  • Diabetes, Gestational / metabolism*
  • Female
  • Humans
  • Inflammation / complications
  • Inflammation / metabolism*
  • Obesity / complications
  • Obesity / metabolism*
  • Oxidative Stress*
  • Periodontal Diseases / complications
  • Periodontal Diseases / metabolism*
  • Pregnancy
  • Pregnancy Complications / metabolism*
  • Saliva / chemistry


  • Biomarkers
  • C-Reactive Protein