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Antepartum periodontitis treatment and risk of offspring screening positive for autism spectrum disorder

Journal of Perinatology volume 43, pages 470–476 (2023)Cite this article

Subjects

Abstract

Background

To evaluate if treating maternal periodontal disease, a pro-inflammatory condition, during pregnancy (intervention) compared to after pregnancy (control) reduces the likelihood of offspring screening positive for autism spectrum disorder (ASD).

Methods

In a follow-up study to the MOTOR randomized trial, we compared rates of positive screens on the Modified Checklist for Autism in Toddlers (M-CHAT) among n = 306 two-year-old toddlers and correlated findings to maternal and cord blood pro-inflammatory interleukin-6 (IL-6).

Results

Toddlers in the intervention group had decreased risk of a positive M-CHAT screen (adjusted RR = 0.53, 95% CI 0.29–0.99). Toddlers screening positive compared to negative had higher mean IL-6 in cord blood (1.58 ± 1.14 vs. 1.09 ± 0.72 p = 0.001) and maternal IL-6 change from baseline (1.30 ± 0.61 vs 0.96 ± 0.62 p = 0.03).

Conclusions

Treating periodontal disease during pregnancy reduced risk of a positive ASD screen. M-CHAT positivity was associated with increased IL-6 in maternal and cord blood.

Clinical trial

Trial Registration numbers: Clinicaltrials.gov NCT03423836.

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Fig. 1: CONSORT diagram.
Fig. 2: Risk of offspring having a positive M-CHAT screen based upon maternal periodontal disease severity during pregnancy.

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Data availability

Deidentified individual participant data (including data dictionaries) will be made available, in addition to study protocols and the informed consent form. The data will be made available upon publication to researchers who provide a methodologically sound proposal for use in achieving the goals of the approved proposal. Proposals should be submitted to jim_beck@unc.edu.

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Acknowledgements

We want to extend our sincerest gratitude to Dr. Steven Offenbacher, the primary investigator of the MOTOR trial. The dental, medical, and scientific communities all had a significant loss with Dr. Offenbacher’s passing. We want to acknowledge the NIH and the MOTOR and MOTORKids investigators and teams. This study was supported by the NIDCR (3U01DE014577) and the NCRR (RR00046, UL1RR025747). We acknowledge the additional grant support of the NIH K01DE027087 (PI JTM) and K23HD105929 (PI GV).

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Author notes

  1. These authors contributed equally: Carl Bose, Gregory C. Valentine.

Authors and Affiliations

  1. Division of Neonatal and Perinatal Medicine, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Carl Bose & Thomas M. O’Shea

  2. Division of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA, USA

    Gregory C. Valentine

  3. Division of Oral Health and Craniofacial Health Sciences, University of North Carolina Adams School of Dentistry, Chapel Hill, NC, USA

    Kamaira Philips, Kevin Moss & Di Wu

  4. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Kim Boggess

  5. Division of Comprehensive Oral Health, Periodontology Unit, University of North Carolina Adams School of Dentistry, Chapel Hill, NC, USA

    Silvana P. Barros, Julie Marchesan & James D. Beck

  6. Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA

    Myriam Peralta-Carcelen

  7. Division of Neonatology, Department of Pediatrics, Kentucky Children’s Hospital, Lexington, KY, USA

    Ricki Goldstein

  8. Division of Neonatology, Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX, USA

    Rajam Ramamurthy

Authors
  1. Carl Bose
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Contributions

CB conceptualized and designed the study, helped draft the initial manuscript, and critically reviewed and revised the manuscript. GV, KP, JB, also helped draft the initial manuscript, critically reviewed and revised the manuscript. KM participated in designing the periodontal disease data collection instruments, collected data, performed data analysis, helped draft, critically reviewed and revised the manuscript. KB, SPB, JM, TMO’S, MP-C, RG, and RR critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Gregory C. Valentine.

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The authors declare no competing interests.

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Bose, C., Valentine, G.C., Philips, K. et al. Antepartum periodontitis treatment and risk of offspring screening positive for autism spectrum disorder. J Perinatol 43, 470–476 (2023). https://doi.org/10.1038/s41372-023-01610-x

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