Inflammation amniotique : son association avec la maladie parodontale et son impact sur le devenir neurologique de l'enfant
|Abstract:||Amniotic inflammation has been associated with preterm birth and adverse long term outcomes in infants born preterm. Its origin and its impact on the outcome of term infants remain unknown. Two projects were accomplished: the first evaluating the role of periodontal disease on intra-amniotic inflammation and preterm birth; the second evaluating the impact of intra-amniotic inflammation on infants’ neurologic development. A prospective cohort of pregnant women who were recruited at the CHU de Québec – Université Laval in Québec city at the time of their midtrimester amniocentesis for fetal karyotype was formed. Among 273 participants, periodontal disease diagnosed in the second trimester was associated with a six-fold increased risk of preeclampsia. However, we did not observe any association between periodontal disease and intra-amniotic inflammation or spontaneous preterm birth. As well, among 709 participants, we observed that intra-amniotic inflammation (defined as levels of interleukin-6 (IL-6) > 1.10 logMoM or levels of matrix metalloproteinase-8 (MMP-8) > 1.09 logMoM), was associated with a two-fold increased risk of delayed gross motor development in the infant at the age of 18 months. Additionally, we observed a dose-response effect, as severe intra-amniotic inflammation was associated with a more important developmental delay. Our results suggest that periodontal disease predisposes pregnant women to the development of preeclampsia. It also suggests that intra-amniotic inflammation early in pregnancy is a risk factor for developmental delay, particularly delayed gross motor skills development. Early screening for intra-amniotic inflammation could allow for an individualized management, as well as research on interventions to treat or to limit the consequences of early amniotic inflammation on infants’ outcome.|
|Document Type:||Mémoire de maîtrise|
|Open Access Date:||24 May 2018|
|Collection:||Thèses et mémoires|
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