Gestational Diabetes Mellitus in Women with Periodontitis Disease: A Cohort Study

Introduction: Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders firstly diagnosed in pregnancy. Periodontal infection is also a localized and chronic inflammation that can trigger the systemic inflammatory response, and some believe it is associated with GDM. There is insufficient evidence to support a link between periodontal disease and GDM. This prospective study aimed to determine the relationship between periodontal disease and GDM. Materials and Methods: This cohort study was performed in the Prenatal Clinic of Rouhani Hospital in Babol from September 2018 to September 2019. The periodontal status of pregnant women in terms of bleeding on probing (BOP), periodontal pocket depth (PPD), clinical attachment loss (CAL), and gingival index (Loe & Silness) at 12 to 24 weeks of gestation by one dentist was examined in the same clinic to diagnose periodontitis cases. Then, at 24 to 28 weeks of gestation, GDM was evaluated based on the 75 g glucose tolerance test. Results: The incidence of GDM was higher in women with periodontitis (P<0.001). The raw relative risk of GDM was 11.94 (CI 95%: 6.21-54.77, P<0.001). The relative risk, adjusted for body mass index, waist circumference, number of pregnancies, and number of deliveries, was 11.23 (CI 95%: 6.20-12.58, P<0.001). The mean GI, CAL, BOP, and PPD were higher in pregnant women with GDM than in the healthy group (P<0.05). Conclusion:To prevent GDM, the early detection and treatment of periodontitis should be a priority in prenatal care, even before pregnancy.