Are Inflammatory Markers and Periodontitis Effective in Predicting Miscarriage?

Background/

Objectives

Miscarriage is a common pregnancy complication that significantly impacts individuals' health due to its physical and psychological effects. This study aimed to investigate the association between periodontal health and hematological parameters in women who experienced miscarriage before the 20th week of gestation, and to assess the potential predictive value of these parameters for miscarriage risk by comparing them with those of women with an uncomplicated pregnancy course.

Methods

This study was a prospective case-control and cross-sectional study. It included a total of 82 participants, comprising 41 women with miscarriage and 41 healthy pregnant controls. The periodontal examinations included measurements of the Gingival Index (GI), Plaque Index (PI), Probing Depth (PD), Clinical Attachment Loss (CAL), and Simplified Calculus Index (SCI). Additionally, complete blood counts (CBCs) were obtained from all participants. Appropriate statistical analyses, including non-parametric, correlation, logistic regression, and ROC analyses, were conducted, with the significance level set at p < 0.05.

Results

The primary outcome measure was CAL as an indicator of periodontal disease severity and its association with miscarriage risk. Additional outcomes included Plateletcrit (PCT), the Platelet Count (PLT), and the Neutrophil-to-Lymphocyte Ratio (NLR) to evaluate systemic inflammatory responses and their correlations with periodontal parameters. CAL was significantly elevated in the miscarriage group (p < 0.001) and emerged as the strongest predictor of miscarriage risk (OR = 0.0537, p < 0.001, AUC = 0.8691). PCT was significantly higher in the miscarriage group (p = 0.017) and positively correlated with the GI (p = 0.041), suggesting a link between systemic inflammation and periodontal health.

Conclusions

Considering this study's limitations, CAL was the strongest predictor of miscarriage, while PLT and PCT had some discriminative power. Collaboration between obstetricians and dentists can facilitate early diagnosis and intervention by promoting routine oral health check-ups before and during pregnancy. Additionally, integrating oral health assessments into prenatal care and developing public health policies could enhance access to dental services during both preconception and pregnancy periods.