Assessment of oral carriage rate of fusobacterium nucleatum among postnatal mothers - An observational study.

BACKGROUND: Preterm birth is defined as childbirth before the 37th week of gestational age, which is highly prevalent worldwide, with 5-18% of births. Fusobacterium nucleatum, an anaerobic oral commensal, is found to be one of the most abundant ubiquitous species in the oral cavity, especially in the subgingival plaque and saliva. This pathogen is strongly associated with intrauterine environment colonization, specifically in amniotic fluid, in up to 70% of pregnant women. It causes adverse pregnancy outcomes like preterm birth, preeclampsia, stillbirth, etc. The potential connection between periodontal disease and other systemic diseases has attracted much research attention in recent decades. However, there is a lacuna in identifying the oral carriage rate of Fusobacterium nucleatum among postnatal mothers by traditional culture methods.

AIMS AND OBJECTIVES: To assess and compare the oral carriage rate of Fusobacterium nucleatum from the whole saliva of preterm delivered and full-term delivered mothers by anaerobic culture technique.

METHODOLOGY: This study involved a total of 70 participants, which included a study group (preterm delivered mothers) and a control group (full-term delivered mothers). Approximately 5ml of whole saliva samples were collected within one hour after delivery, in a sterile container spitting method. The samples were diluted and centrifuged at 1400 rpm, then inoculated into the crystal violet erythromycin agar. Anaerobic incubation will be done at 37˚C for 2 days. After 48 hours, the colony-forming units (CFU) were documented based on counting the variable growth of cream/white colored, smooth, and pasty colonies of Fusobacterium nucleatum. The surface spread method was used for counting the colony-forming units. The data obtained were subjected to statistical analysis by using the unpaired Student's t-test.

RESULTS: Mothers who delivered preterm babies (birth weight 37 <weeks) had a significantly higher mean (22.77 ± 10.96) of salivary Fusobacterium nucleatum colony-forming units (CFUs) compared to the mean value (7.71 ± 5.78) of mothers who delivered full-term babies (birth weight ≥37 weeks).

CONCLUSION: This observational study showed statistically significant increases in CFU of Fusobacterium nucleatum in preterm labored mothers than in normal term labored mothers. Therefore, oral screening and oral treatment need to be integrated during preconception care, and oral health maintenance should be a concern throughout the pregnancy to prevent further postnatal complications and adverse pregnancy outcomes.