This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Gestational Diabetes Mellitus (GDM) occurs in approximately 5% of pregnant women with onset during pregnancy, and subsiding after parturition. Importantly nearly 50% of women with GDM will eventually develop type 2 diabetes mellitus within 3-5 years post-partum. Moreover, acute and chronic neonatal morbidity and mortality have been described in neonates delivered by women with GDM. Substantial evidence is available documenting that the severity of periodontal disease is increased in patients with type 2 diabetes but no data are available on the effects of GDM on periodontal health. In addition, substantial data is accruing to support earlier observations that the infection and inflammation associated with periodontal disease may have a negative impact on the period of gestation and on fetal growth leading to the birth of preterm, low birth weight infants. Our GENERAL HYPOTHESIS is that women with GDM are at higher risk for developing more severe periodontal disease than women without GDM and that the combination of GDM and periodontal disease will be associated with an increased negative impact on maternal and fetal health. This hypothesis will be tested by collecting (a) clinical oral health data on periodontal status, as well as maternal and fetal outcomes data (Specific Aim 1), (b) microbial dental plaque samples (Specific Aim 2) and (c) serum samples in women with GDM and in non-GDM controls (Specific Aim 3). These prospective clinical data will be correlated with basic science laboratory evaluations of the microflora and host response to provide insight into the pathogenic mechanisms contributing to negative maternal and fetal outcomes associated with inflammatory periodontal disease and GDM. To date, 25 subjects have enrolled in the study. The appropriate data have been collected on all subjects. Enrollment will continue in the coming year. Collected data will be subjected to statistical analyses at the mid-point and at the end of the study.
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