Fusobacterim nucleatum, periodontal diseases, and preterm birth: a literature review

Relevance. Preterm birth is a serious pregnancy complication and remains a leading cause of neonatal morbidity and mortality. Fusobacterium nucleatum, a member of the normal oral microbiota, has been implicated during pregnancy in the development of gingivitis and periodontitis, which may, in turn, contribute to adverse pregnancy outcomes, including preterm birth.

Materials and methods. The primary electronic databases searched were PubMed/MEDLINE, Scopus, and eLIBRARY. ru. Additional sources were identified through reference lists of relevant reviews and consensus reports. No restriction on the start date of the search was applied. Search strategies included terms related to periodontal diseases (“periodontitis,” “gingivitis,” “periodontal infection”), pregnancy outcomes (“preterm birth,” “prematurity,” “low birth weight,” “stillbirth,” “chorioamnionitis”), oral and placental microbiology (“oral microbiome,” “intra-amniotic infection”), and Fusobacterium nucleatum (“Fusobacterium,” “F. nucleatum,” “FadA,” “Fap2,” “polymicrobial interactions”).

Results. During pregnancy, F. nucleatum acquires the ability to proliferate actively. As a result of immunological, endocrine, and other physiological changes in the maternal physiology, its levels in periodontal tissues may increase by up to 10,000-fold, contributing to the development of periodontal diseases. The bacterium possesses virulence factors—primarily adhesins—that facilitate hematogenous dissemination from the oral cavity and amplification of systemic inflammation. Experimental studies have demonstrated that F. nucleatum can induce chorioamnionitis and, through increased prostaglandin production, stimulate uterine contractions, ultimately leading to preterm birth. Early-stage non-surgical periodontal therapy (during pregnancy planning and the first trimester) has been shown to reduce the incidence of preterm birth.

Conclusion. Comprehensive examination of women at the pregnancy planning stage and timely management of periodontal and other oral diseases may contribute to the prevention of obstetric complications. A preventive approach to F. nucleatum–associated preterm birth warrants further attention and investigation by obstetricians, dentists, and microbiologists.

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