Preeclampsia, periodontitis and their interactions on cardiometabolic risk markers in pregnancy: A case-control study

Abstract

Objective: Preeclampsia and periodontitis are characterised by altered lipid metabolism. Meta-analyses indicate a higher risk of preeclampsia among women with periodontitis, suggesting a plausible biological connection. Understanding their interaction on fasting lipid levels may reveal targets for integrated strategies to reduce maternal and cardiometabolic risks. Methods: This case-control study was conducted at the Tamale Teaching Hospital from January to September 2025. The study involved 155 pregnant women, ≥ 20 weeks of gestation, including 52 (33.5%) diagnosed with preeclampsia. The women were aged between 19 and 45 years. All the women underwent periodontal examination before a fasting venous blood sample was collected, and then analysed for fasting lipids. Results: Results showed that preeclampsia was associated [adjusted odds ratio (95%CI)] with periodontal diseases [3.079 (1.414-6.704)] and, particularly, periodontitis [8.905 (3.574-22.188)]. Sub-group analysis showed that the comorbidity of preeclampsia and periodontitis was characterised by higher levels (mmol/L) of total cholesterol (6.4±1.4 vs 4.9±0.7, P<0.010), low-density lipoprotein cholesterol (4.4±1.2 vs 3.0±0.7, P<0.001), and non-high-density lipoprotein cholesterol (5.1±1.3 vs 3.6±0.8, P<0.010) than preeclampsia alone. However, no significant differences in fasting lipids were observed between normotensive pregnant women with and without periodontitis. Moreover, there were significant interactions between preeclampsia and periodontitis on fasting lipid levels. Conclusion: The study demonstrates a distinct dysregulated lipid profile among preeclamptic women, which appears to be significantly exacerbated by the presence of periodontitis. These results highlight the need for an integrated antenatal care that includes periodontal screening and management, particularly in women at high risk for preeclampsia.