Periodontitis and pre-eclampsia among pregnant women in Rwanda: A case-control study

PLoS One. 2024 Oct 14;19(10):e0312103. doi: 10.1371/journal.pone.0312103. eCollection 2024.

Abstract

Introduction: Several studies have indicated that the presence of periodontitis during pregnancy could increase the risk of developing pre-eclampsia, thereby negatively influencing pregnancy outcomes for both the mother and child. Notably, despite the high prevalence of both periodontitis and adverse pregnancy outcomes in Rwanda, there exists a crucial evidence gap concerning the precise relationship between periodontitis and pre-eclampsia.

Objectives: The aim of this study was to assess the association between periodontitis and pre-eclampsia amongst pregnant women in Rwanda.

Methods and materials: Employing an unmatched 1:2 case-control design, we studied 52 pre-eclamptic and 104 non-pre-eclamptic pregnant women aged ≥18 years at two referral hospitals in Rwanda. Pre-eclampsia was defined as a systolic blood pressure ≥ 140 and diastolic blood pressure ≥ 90 mm Hg, diagnosed after 20 weeks of gestation and proteinuria of ≥300mL in 24 hours of urine collection. Periodontitis was defined as the presence of two or more teeth with one or more sites with a pocket depth ≥ 4mm and clinical attachment loss >3 mm at the same site, assessed through clinical attachment loss measurement. Bivariate analysis and logistic regression were used to estimate Odds ratio (ORs) and 95% confidence interval.

Results: The prevalence of periodontitis was significantly higher among women with pre-eclampsia, compared to pregnant women without pre-eclampsia, at 90.4% and 55.8%, respectively (p< 0.001). Pregnant Women with periodontitis were 3.85 times more likely to develop pre-eclampsia after controlling for relevant confounders (adjusted Odds Ratio [aOR] = 3.85, 95%CI = 1.14-12.97, p<0.05).

Conclusion: This study results indicates that periodontitis is significantly associated with pre-eclampsia among pregnant women in Rwanda. These findings suggest that future research should explore whether enhancing periodontal health during pregnancy could contribute to reducing pre-eclampsia in this specific population.

MeSH terms

  • Adolescent
  • Adult
  • Case-Control Studies
  • Female
  • Humans
  • Periodontitis* / complications
  • Periodontitis* / epidemiology
  • Pre-Eclampsia* / epidemiology
  • Pregnancy
  • Prevalence
  • Risk Factors
  • Rwanda / epidemiology
  • Young Adult

Grants and funding

This research received funding from the Capacity Building for Female Scientists in East Africa Africa program (CaFe-SEA) under the East African Consortium for Clinical Research (EACCR) partner’s institution funded by EDCTP and University of Rwanda-Sweden collaboration. These had no other involvement for this study.