Periodontal Status and Thyroid Markers in Pregnancy

Periodontal Status and Thyroid Markers in Pregnancy :A Cross- Sectional Study

This cross-sectional study aims to evaluate the association between periodontal status and serum thyroid markers among 100 systemically healthy pregnant women aged 18-45 years in the second trimester (13-27 weeks). Pregnancy is characterized by profound hormonal and immunological changes that influence both periodontal health and thyroid function. While periodontal inflammation has been associated with thyroid dysfunction in the general population, no study has explored this relationship during pregnancy. Participants will be recruited from the Department of Gynaecology, PGIMS, Rohtak, and undergo comprehensive periodontal examination, including periodontal inflamed surface area (PISA), probing pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and plaque index (PI). Blood samples will be collected to assess thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), anti-thyroid peroxidase (Anti-TPO) antibodies, and high-sensitivity C-reactive protein (hsCRP). The primary objective is to determine the association between PISA and serum TSH levels, while secondary objectives include evaluating the relationship of periodontal parameters with T3, T4, Anti-TPO, hsCRP, and the distribution of thyroid profiles (euthyroid, hypothyroid, and hyperthyroid) according to periodontal status. Data will be analyzed using appropriate descriptive statistics, Pearson/Spearman correlation, and multiple linear regression after testing for normality. By investigating the interplay between periodontal inflammation and thyroid function during pregnancy, this study seeks to generate novel evidence that may support integrated periodontal and antenatal care strategies, ultimately contributing to improved maternal and fetal health outcomes.

Inclusion Criteria:

• Pregnant women aged 18-45 years
• Singleton pregnancy
• Gestational age between 13 and 27 weeks (second trimester)
• Presence of ≥20 natural teeth (excluding third molars)
• Willingness to participate in the study and provide written informed consent
• Attendance at the antenatal clinic during the study period
• Ability to undergo full-mouth periodontal examination

Exclusion Criteria:

• History of previously diagnosed thyroid disorders (diagnosed prior to pregnancy or currently)
• Current use of thyroid-related medication
• Presence of systemic diseases known to affect periodontal status or inflammatory response (e.g., diabetes mellitus, gestational diabetes mellitus, autoimmune diseases, cardiovascular disorders)
• Use of antibiotics, anti-inflammatory drugs, corticosteroids, or immunosuppressive agents within the previous 3 months
• Current or past tobacco use in any form (smoking or smokeless)
• Alcohol consumption during pregnancy
• Multiple gestations (e.g., twin or higher-order pregnancy)
• History of periodontal therapy or professional dental cleaning within the last 6 months
• Presence of acute infections or inflammatory conditions at the time of examination
• Pregnancy-related complications such as gestational diabetes mellitus, preeclampsia, or threatened abortion
• Inability or unwillingness to comply with study procedures
• Presence of acute oral infections or inflammatory conditions at the time of examination (periapical abscess, acute pericoronitis)