Sex Steroid Levels and Stress-related Markers in Pregnant and Non-pregnant Women and the Effect of Periodontal Therapy

Overview

Journal Med Oral Patol Oral Cir Bucal

Specialty Dentistry

Date 2024 Feb 18

PMID 38368525

Authors

O Gokturk

F-U Yarkac

F Avcioglu

Affiliations

Soon will be listed here.

Abstract

Background: Periodontal disease during pregnancy can produce adverse events; in the current study stress was investigated as an exacerbating factors of periodontal disease. The aims of this study were to evaluate the possible associations between stress and pregnancy through scanning for gingivitis and to explore the effect of non-surgical periodontal therapy (NPT) on stress-related markers (CgA, AA, β-endorphin, DHEA, sIgA and NPY) and sex steroid levels (estrogen and progesterone) in pregnant and non-pregnant women.

Material And Methods: A total of 87 subjects; 22 pregnant women with gingivitis, 25 periodontally healthy pregnant women; 22 non-pregnant women with gingivitis and 15 periodontally healthy non-pregnant women, participated in this study. Periodontal clinical measures, stress hormones and sex steroid levels were measured at baseline and following the periodontal therapy.

Results: While periodontal therapy showed an improvement in salivary CgA, AA, β-endorphin, DHEA, and sIgA levels (p<0.05) in non-pregnant women with gingivitis; neuropeptide Y levels were found to be unaffected (p>0.05). There were no significant changes in salivary CgA, AA, DHEA, sIgA, and neuropeptide Y levels in pregnant women with gingivitis (p>0.05); however, a decrease in β-endorphin levels was observed after therapy (p<0.05). Pregnant women with gingivitis had higher gingival crevicular fluid (GCF) β-endorphin levels in comparison to non-pregnant women with gingivitis.

Conclusions: Gingival inflammation can be a psychosocial stress inducing factor during pregnancy. Furthermore, periodontal therapy may assist in reducing stress-related hormone levels in GCF during pregnancy.

Citing Articles

Oral Health, Anxiety, Depression, and Stress in Pregnancy: A Rapid Review of Associations and Implications for Perinatal Care.

Adeniyi A, Ramachandran S, Jevitt C Int J Environ Res Public Health. 2025; 22(1).

PMID: 39857485 PMC: 11765242. DOI: 10.3390/ijerph22010032.

References

Gursoy M, Gursoy U, Sorsa T, Pajukanta R, Kononen E . High salivary estrogen and risk of developing pregnancy gingivitis. J Periodontol. 2012; 84(9):1281-9. DOI: 10.1902/jop.2012.120512. View

Sanders V, Straub R . Norepinephrine, the beta-adrenergic receptor, and immunity. Brain Behav Immun. 2002; 16(4):290-332. DOI: 10.1006/brbi.2001.0639. View

Dolomatov S, Zukow W, Atmazhov I, Muszkieta R, Skaliy A . The use of hormones indicators in human saliva in diagnosing parodontitis in pregnant women. Indian J Hum Genet. 2013; 18(3):305-9. PMC: 3656519. DOI: 10.4103/0971-6866.107982. View

Golshiri P, Pourabdian S, Najimi A, Zadeh H, Hasheminia J . Job stress and its relationship with the level of secretory IgA in saliva: a comparison between nurses working in emergency wards and hospital clerks. J Pak Med Assoc. 2012; 62(3 Suppl 2):S26-30. View

Haririan H, Andrukhov O, Bottcher M, Pablik E, Wimmer G, Moritz A . Salivary neuropeptides, stress, and periodontitis. J Periodontol. 2017; 89(1):9-18. DOI: 10.1902/jop.2017.170249. View

Helle K . Regulatory peptides from chromogranin A and secretogranin II: putative modulators of cells and tissues involved in inflammatory conditions. Regul Pept. 2009; 165(1):45-51. DOI: 10.1016/j.regpep.2009.09.009. View

Rose W, Rone J, Movafagh S, Ji H, Yeh Y, Chen W . Neuropeptide Y: a novel angiogenic factor from the sympathetic nerves and endothelium. Circ Res. 1998; 83(2):187-95. DOI: 10.1161/01.res.83.2.187. View

Chen P, Yang L, Chou C, Li C, Chang Y, Liaw J . Effects of prenatal yoga on women's stress and immune function across pregnancy: A randomized controlled trial. Complement Ther Med. 2017; 31:109-117. DOI: 10.1016/j.ctim.2017.03.003. View

Decker A, Askar H, Tattan M, Taichman R, Wang H . The assessment of stress, depression, and inflammation as a collective risk factor for periodontal diseases: a systematic review. Clin Oral Investig. 2019; 24(1):1-12. PMC: 6980776. DOI: 10.1007/s00784-019-03089-3. View

10.

Ahmed A, Albalawi A, Alshehri A, AlBlaihed R, Alsalamah M . Stress and its predictors in pregnant women: a study in Saudi Arabia. Psychol Res Behav Manag. 2017; 10:97-102. PMC: 5391829. DOI: 10.2147/PRBM.S131474. View

11.

McCullough J, Liddle S, Close C, Sinclair M, Hughes C . Reflexology: A randomised controlled trial investigating the effects on beta-endorphin, cortisol and pregnancy related stress. Complement Ther Clin Pract. 2018; 31:76-84. DOI: 10.1016/j.ctcp.2018.01.018. View

12.

Seraphim A, Chiba F, Pereira R, Mattera M, Moimaz S, Sumida D . Relationship among Periodontal Disease, Insulin Resistance, Salivary Cortisol, and Stress Levels during Pregnancy. Braz Dent J. 2016; 27(2):123-7. DOI: 10.1590/0103-6440201600596. View

13.

Ucan Yarkac F, Gokturk O, Demir O . Effect of non-surgical periodontal therapy on the degree of gingival inflammation and stress markers related to pregnancy. J Appl Oral Sci. 2018; 26:e20170630. PMC: 6063465. DOI: 10.1590/1678-7757-2017-0630. View

14.

Rohleder N, Nater U . Determinants of salivary alpha-amylase in humans and methodological considerations. Psychoneuroendocrinology. 2009; 34(4):469-85. DOI: 10.1016/j.psyneuen.2008.12.004. View

15.

Gallacher D, Petersen O . Stimulus-secretion coupling in mammalian salivary glands. Int Rev Physiol. 1983; 28:1-52. View

16.

Loe H . The Gingival Index, the Plaque Index and the Retention Index Systems. J Periodontol. 1967; 38(6):Suppl:610-6. DOI: 10.1902/jop.1967.38.6.610. View

17.

Taani D, Habashneh R, Hammad M, Batieha A . The periodontal status of pregnant women and its relationship with socio-demographic and clinical variables. J Oral Rehabil. 2003; 30(4):440-5. DOI: 10.1046/j.1365-2842.2003.01058.x. View

18.

Chambrone L, Guglielmetti M, Pannuti C, Chambrone L . Evidence grade associating periodontitis to preterm birth and/or low birth weight: I. A systematic review of prospective cohort studies. J Clin Periodontol. 2011; 38(9):795-808. DOI: 10.1111/j.1600-051X.2011.01755.x. View

19.

Sanchez G, Miozza V, Delgado A, Busch L . Determination of salivary levels of mucin and amylase in chronic periodontitis patients. J Periodontal Res. 2010; 46(2):221-7. DOI: 10.1111/j.1600-0765.2010.01332.x. View

20.

Johannsen A, Rylander G, Soder B, Asberg M . Dental plaque, gingival inflammation, and elevated levels of interleukin-6 and cortisol in gingival crevicular fluid from women with stress-related depression and exhaustion. J Periodontol. 2006; 77(8):1403-9. DOI: 10.1902/jop.2006.050411. View