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Association between periodontal disease and gestational diabetes mellitus—A prospective cohort study

AIM
This study aimed to determine the association between periodontal disease and gestational diabetes mellitus (GDM) and the effect of this association on pregnancy outcome in North Indian population.


MATERIALS AND METHODS
A total of 584 primigravidae were recruited at 12-14 weeks of gestation. Their periodontal examination was carried out along with 75 g oral glucose load test at the time of recruitment. GDM was diagnosed as per the DIPSI (The Diabetes in Pregnancy Study group India) guidelines (≥140 mg/dl). Women with normal plasma glucose values underwent a repeat 75 g oral glucose load test at 24-28 weeks of gestation. All patients were followed up for pregnancy outcomes.


RESULTS
Of 584 primigravida, 184 (31.5%) had gingivitis and 148 (25.3%) had periodontitis. Overall, 332 (56.8%) pregnant women had periodontal disease. It was associated with GDM with adjusted hazard ratio (aHR) of 2.85 (95%CI = 1.47-5.53). The occurrence of pre-eclampsia was associated with periodontal disease with aHR of 2.20 (95%CI = 0.86-5.60). If primigravidae had periodontal disease along with GDM, the risk of pre-eclampsia had shown increased aHR of 18.79 (95% CI = 7.45-47.40).


CONCLUSIONS
The study shows a significant association of periodontal disease with GDM and an increased risk of developing pre-eclampsia due to this association.