Oral Microbiome and Preterm Birth: Correlation or Coincidence? A Narrative Review

Authors

  • Biagio Rapone Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy
  • Elisabetta Ferrara Complex Operative Unit of Odontostomatology, Chieti, Italy
  • Nicola Montemurro Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy
  • Ilaria Converti Department of Emergency and Organ Transplantation, Division of Plastic and Reconstructive Surgery, University of Bari Aldo Moro, Bari, Italy
  • Matteo Loverro Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
  • Maria Teresa Loverro Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
  • Antonio Gnoni Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy
  • Salvatore Scacco Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy
  • Luisa Siculella Department of Biological and Technologies, University of Salento, Lecce, Italy
  • Massimo Corsalini Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy
  • Edoardo Di Naro Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy

DOI:

https://doi.org/10.3889/oamjms.2020.4444

Keywords:

Oral microbiome, Microbiome, Preterm birth, Periodontal pathogens, Placental inflammation

Abstract

BACKGROUND: Physiological changes that occur during pregnancy involve, as a natural consequence, also modifications of oral microbiome. However, the addition with microbial imbalance due to pre-existing periodontal infection might impair a pathological alteration in the phylogenetic community structure and composition in the oral cavity, exacerbating an inflammatory status, and becoming a potential risk factor for preterm birth. From the empirical findings about the relationship between periodontal pathogens and systemic diseases, a clear interest focused on the potential impact of some periodontal pathogens on the preterm birth risk has emerged.

AIM: Exploration of the potential interdependence existing between dysbiosis of oral microbiome and changes in maternal-fetal barrier in premature rupture of membranes.

MATERIALS AND METHODS: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a Medline search was performed for studies focusing on oral microbioma and its association with pre-term birth, and completed by additional hand searching. Two reviewers independently selected studies and extracted data. The search was restricted to only reports written in English.

RESULTS: The electronic search produced 66 items. Six duplicates were found. Among the collected studies, 56 were discarded because they met the exclusion criteria. The articles and reports in our review showed a connection between preterm birth and altered oral microbiome, suggesting a potential key role of Fusobacterium nucleatum, a notable periodontal pathogen involved in several pathological periodontal conditions, in increasing the risk of premature birth.

CONCLUSIONS: Since F. nucleatum is frequently associated with preterm birth, it is coherent to hypothesize a potential role for the oral microbiota for preterm birth risk. Further studies should be carried out to determine the changes of the oral microflora in pregnancy and to provide comprehensive knowledge of the diversity of oral bacteria involved in preterm birth.

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References

Minozzi F, Chipaila N, Unfer V, Minozzi M. Odontostomatological approach to the pregnant patient. Eur Rev Med Pharmacol Sci. 2008;12(6):397-409. PMid:19146202

Rodrigues AS, Ariana S, Lima DB. Preterm and low birth weight and the relationship with periodontal disease: Clinical, microbiological and immunological aspects. Rev Odontol UNICID. 2004;16:55-61.

Vinturache AE, Gyamfi-Bannerman C, Hwang J, Mysorekar IU, Jacobsson B. Preterm birth international collaborative (PREBIC). Maternal microbiome a pathway to preterm birth. Semin Fetal Neonatal Med. 2016;21(2):94-9. PMid:26936188

Igari K, Kudo T, Toyofuku T, Inoue Y, Iwai T. Association between periodontitis and the development of systemic diseases. Oral Biol Dent. 2014;2:4.

Seymour GJ, Ford PJ, Cullinan MP, Leishman S, Yamazaki K. Relationship between periodontal infections and systemic disease. Clin Microbiol Infect. 2007;13(Suppl 4):3-10. PMid:17716290

Gürsoy M, Pajukanta R, Sorsa T, Könönen E. Clinical changes in periodontium during pregnancy and postpartum. J Clin Periodontol. 2008;35(7):576-83. PMid:18430046

Russell SL, Mayberry LJ. Pregnancy and oral health: A review and recommendations to reduce gaps in practice and research. MCN Am J Mat Child Nurs. 2008;33(1):32-7. PMid:18158525

Silk H, Douglass AB, Douglass JM, Silk L. Oral health during pregnancy. Am Fam Physician. 2008;77:1139-44. PMid:18481562

Lindhe J. Clinical Periodontology and Implant Dentistry. 3rd ed. Copenhagen: Blackell Munksgard; 1997. p. 1-72.

Szulc M, Kustrzycki W, Janczak D, Michalowska D, Baczynska D, Radwan-Oczko M. Presence of periodontopathic bacteria DNA in atheromatous plaques from coronary and carotid arteries. BioMed Res Int. 2015;2015:825397. PMid:26504835

Chistiakov DA, Orekhov AN, Bobryshev YV. Links between atherosclerotic and periodontal disease. Exp Mol Pathol. 2016;100(1):220-35. PMid:26777261

Hansen GM, Egeberg A, Holmstrkup P, Hansen PR. Relation of periodontitis to risk of cardiovascular and all-cause mortality (from a Danish nationwide cohort study). Am J Cardiol. 2016;118(4):489-93. PMid:27372888

Orlandi M, Suvan J, Petrie A, Donos N, Masi S, Hingorani A, et al. Association between periodontal disease and its treatment, flow-mediated dilatation and carotid intima-media thickness: A systematic review and meta-analysis. Atheroscler. 2014;236(1):39-46. PMid:25014033

Lafon A, Pereira B, Dufour T, Rigouby V, Giroud M, Béjot Y, et al. Periodontal disease and stroke: A meta-analysis of cohort studies. Eur J Neurol. 2014;21(9):1155-61, e66-7. PMid:24712659

Lafon A, Tala S, Ahossi V, Perrin D, Giroud M, Béjot Y. Association between periodontal disease and non-fatal ischemic stroke: A case-control study. Acta Odont Scand. 2014;72(8):687-93. PMid:24720864

Gaur S, Agnihotri R. Alzheimer’s disease and chronic periodontitis: Is there an association? Geriatrics Gerontol Int. 2015;15(4):391-404. PMid:25511390

Martande SS, Pradeep AR, Singh SP, Kumari M, Suke DK, Raju AP, et al. Periodontal health condition in patients with Alzheimer’s disease. Am J Alzheimers Dis Other Dement. 2014;29(6):498-502. PMid:25214647

Cobb CM, Kelly PJ, Williams KB, Babbar S, Angolkar M, Derman RJ. The oral microbiome and adverse pregnancy outcomes. Int J Womens Health. 2017;9:551-9. PMid:28848365

Baskaradoss JK, Geevarghese A, Al Dosari AA. Causes of adverse pregnancy outcomes and role of maternal periodontal status a review of the literature. Open Dent J. 2012;6:79-84. PMid:22615718

Papapanou PN. Systemic effects of periodontitis: Lessons learned from research on atherosclerotic vascular disease and adverse pregnancy outcomes. Int Dent J. 2015;65(6):283-91. PMid:26388299

Madianos PN, Bobetsis YA, Offenbacher S. Adverse pregnancy outcomes (APOs) and periodontal disease: Pathogenic mechanisms. J Clin Periodontol. 2013;40(Suppl 14):S170-80. PMid:23631577

Steinberg BJ, Hilton IV, Iida H, Samelson R. Oral health and dental care during pregnancy. Dent Clin North Am. 2013;57(2):195-210. PMid:23570802

Yang I, Knight AK, Dunlop AL, Corwin EJ. Characterizing the subgingival microbiome of pregnant African American women. J Obstet Gynecol Neonatal Nurs. 2019;48(2):140-52. PMid:30597136

Han YW, Ikegami A, Bissada NF, Herbst M, Redline RW, Ashmead GG. Transmission of an uncultivated Bergeyella strain from the oral cavity to amniotic fluid in a case of preterm birth. J Clin Microbiol. 2006;44(4):1475-83. PMid:16597879

Min W, Shao-Wu C, Shao-Yun J. Relationship between gingival inflammation and pregnancy. Mediators Inflamm. 2015;2015:623427. PMid:25873767

Han YW, Ikegami A, Rajanna C, Kawsar HI, Zhou Y, Li M, et al. Identification and characterization of a novel adhesin unique to oral fusobacteria. J Bacteriol. 2014;187(15):5330-40. PMid:16030227

Bjorby A, Löe H. The relative significance of different local factors in the initiation and development of periodontal inflammation. J Periodontal Res. 1967;2:76-7.

Lang NP, Liel RA, Anderhalden K. Clinical andmicrobiological effects of subgingival restorations with overhanging or clinically perfect margins. J Clin Periodontol. 1983;10:563-78. PMid:6581173

Armitage GC. Bi-directional relationship between pregnancy and periodontal disease. Periodontol 2000. 2013;61(1):160-76. PMid:23240948

Lindhe J, Karring T, Lang NP. Fatores modificadores. In: Tratado de Periodontia Clínica e Implantologia Oral. 5nd ed. Rio de Janeiro: Guanabara Koogan; 2010. p. 292-311.

Nardi GM, Grassi R, Grassi FR, Aragona SE, Rapone B, Vella FD, et al. Use of photobiomodulation induced by polarized polychromatic non-coherent light in the management of adult chronic periodontitis. J Biol Regul Homeost Agents. 2019;33(1):293-7. PMid:30666859

Brummaier T, Kabeer BS, Lindow S, Konje JC, PukrittayaameeS, Utzinger J, et al. Prospective cohort for the investigation of alteration in temporal transcriptional and microbiome trajectories preceding preterm birth: A study protocol. BMJ Open. 2019;9(1):e023417.

Carinci F, Martinelli M, Contaldo M, Santoro R, Pezzetti F, Lauritano D, et al. Focus on periodontal disease and development of endocarditis. J Biol Regul Homeost Agents. 2018;32(2 Suppl 1):143-7. PMid:29460534

Chu DM, Seferovic M, Pace RM, Aagaard KM. The microbiome in preterm birth. Best Pract Res Clin Obstet Gynaecol. 2018;52:103-13. PMid:29753695

Corwin EJ, Hogue CJ, Pearce B, Hill CC, Read TD, Mulle J, et al. Protocol for the emory university african american vaginal, oral, and gut microbiome in pregnancy cohort study. BMC Pregnancy Childbirth. 2017;17(1):161. PMid:28571577

Vettore MV, Leão AT, Mdo CL, Feres M, Sheiham A. The relationship between periodontal disease and preterm low birthweight: Clinical and microbiological results. J Periodontal Res. 2008;43(6):615-26. PMid:18702632

Yang S, Reid G, Challis JR, Kim SO, Gloor GB, Bocking AD. Is there a role for probiotics in the prevention of preterm birth? Front Immunol. 2015;6:62. PMid:25741339

Fardini Y, Chung P, Dumm R, Joshi N, Han YW. Transmission of diverse oral bacteria to murine placenta: Evidence for the oral microbiome as a potential source of intrauterine infection. Infect Immun. 2010;78(4):1789-96. PMid:20123706

Han YW, Redline RW, Li L, Yin M, Hill GB, McCormick TS. Fusobacterium nucleatum induces premature and term stillbirths in pregnant mice: Implication of oral bacteria in preterm birth. Infect Immun. 2004;72(4): 2272-9. PMid:15039352

Nithianantham S, Xu M, Yamada M, Ikegami A, Shoham M, Han YW. Crystal structure of FadA adhesin from Fusobacterium nucleatum reveals a novel oligomerization motif, the leucine chain. J Biol Chem. 2009;284(6):3865-72. PMid:18996848

Ikegami A, Chung P, Han YW. Complementation of the fadA mutation in Fusobacterium nucleatum demonstrates that the surface-exposed adhesin promotes cellular invasion and placental colonization. Infect Immun. 2009;77(7):3075-9. PMid:19398541

Fardini Y, Wang X, Témoin S, Nithianantham S, Lee D, Shoham M, et al. Fusobacterium nucleatum adhesion FadA binds vascular-endothelial cadherin and alters endothelial integrity. Mol Microbiol. 2011;82(6):1468-80. PMid:22040113

Costello EK, Carlisle EM, Bik EM, Morowitz MJ, Relman DA. Microbiome assembly across multiple body sites in lowbirthweight infants. MBio. 2013;4(6):e00782-13. PMid:24169577

DiGiulio DB, Callahan BJ, McMurdie PJ, Costello EK, Lyell DJ, Robaczewska A, et al. Temporal and spatial variation of the human microbiota during pregnancy. Proc Natl Acad Sci USA. 2015;112(35):11060-5. PMid:26283357

Gonzales-Marin C, Spratt DA, Allaker RP. Maternal oral origin of Fusobacterium nucleatum in adverse pregnancy outcomes as determined using the 16S-23S rRNA gene intergenic transcribed spacer region. J Med Microbiol. 2013;62(Pt 1):133-44. PMid:23002071

Grev J, Berg M, Soll R. Maternal probiotic supplementation for prevention of morbidity and mortality in preterm infants. Cochrane Database Syst Rev. 2018;12(12):CD012519. PMid:30548483

He J, Li Y, Cao Y, Xue J, Zhou X. The oral microbiome diversity and its relation to human diseases. Folia Microbiol (Praha). 2015;60(1):69-80. PMid:25147055

Morban DA. Preterm delivery and intimacy during pregnancy: Interaction between oral, vaginal and intestinal microbiomes. Medwave. 2015;15(4):e6144. PMid:26056839

Mysorekar IU, Cao B. Microbiome in parturition and preterm birth. Semin Reprod Med. 2014;32(1):50-5. PMid:24390921

Solt I. The human microbiome and the great obstetrical syndromes: A new frontier in maternal-fetal medicine. Best Pract Res Clin Obstet Gynaecol. 2015;29(2):165-75. PMid:25242582

Strus M, Helwich E, Lauterbach R, Rzepecka-Węglarz B, Nowicka K, Wilińska M, et al. Effects of oral probiotic supplementation on gut Lactobacillus and Bifidobacterium populations and the clinical status of low-birth-weight preterm neonates: A multicenter randomized, double-blind, placebocontrolled trial. Infect Drug Resist. 2018;11:1557-71. PMid:30288066

Han YW, Shi W, Huang GT, Haake SK, Park NH, Kuramitsu H, et al. Interactions between periodontal bacteria and human oral epithelial cells: Fusobacterium nucleatum adheres to and invades epithelial cells. Infect Immun. 2000;68(6)3140-6. PMid:10816455

Jeffcoat M, Parry S, Sammel M, Clothier B, Catlin A, Macones G. Periodontal infection and preterm birth: Successful periodontal therapy reduces the risk of preterm birth. BJOG. 2011;118(2):250-6. PMid:20840689

Tettamanti L, Lauritano D, Nardone M, Gargari M, SilvestreRangil J, Gavoglio P, et al. Pregnancy and periodontal disease: Does exist a two-way relationship? Oral Implantol (Rome). 2017;10(2):112-8. PMid:29876036

Boggess KA, Moss K, Madianos P, Murtha AP, Beck J, Offenbacher S. Fetal immune response to oral pathogens and risk of preterm birth. Am J Obstet Gynecol. 2005;193(3 Pt 2):1121-6. PMid:16157123

Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G, et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol. 1996;67(Suppl 10):1103-13. PMid:8910829

Konopka T, Paradowska-Stolarz A. Periodontitis and risk of preterm birth and low birth weight a meta-analysis. Ginekol Pol. 2012;83(6):446-53. PMid:22880465

León R, Silva N, Ovalle A, Chaparro A, Ahumada A, Gajardo M, et al. Detection of Porphyromonas gingivalis in the amniotic fluid in pregnant women with a diagnosis of threatened premature labor. J Periodontol. 2007;78(7):1249-55. PMid:17608580

Xiong X, Buekens P, Goldenberg RL, Offenbacher S, Qian X. Optimal timing of periodontal disease treatment for prevention of adverse pregnancy outcomes: Before or during pregnancy? Am J Obstet Gynecol. 2011;205(2):111e1-6. PMid:21620355

Wei BJ, Chen YJ, Yu L, Wu B. Periodontal disease and risk of preeclampsia: A meta-analysis of observational studies. PLoS One. 2013;8(8):e70901. PMid:23951033

Chambrone L, Guglielmetti MR, Pannuti CM, Chambrone LA. Evidence grade associating periodontitis to preterm birth and/ or low birth weight: I. A systematic review of prospective cohort studies. J Clin Periodontol. 2011;38(9):795-808. PMid:21707694

Kunnen A, van Doormaal JJ, Abbas F, Aarnoudse JG, van Pampus MG, Faas MM. Periodontal disease and pre-eclampsia: A systematic review. J Clin Periodontol. 2010;37(12):1075-87 PMid:21070324

Kim AJ, Lo AJ, Pullin DA, Thornton-Johnson DS, Karimbux NY. Scaling and root planing treatment for periodontitis to reduce preterm birth and low birth weight: A systematic review and meta-analysis of randomized controlled trials. J Periodontol. 2012;83(12):1508-19. PMid:22376207

Schwendicke F, Karimbux N, Allareddy V, Gluud C. Periodontal treatment for preventing adverse pregnancy outcomes: A metaand trial sequential analysis. PLoS One. 2015;10(6):e0129060. PMid:26035835

Manau C, Echeverria A, Agueda A, Guerrero A, Echeverria JJ. Periodontal disease definition may determine the association between periodontitis and pregnancy outcomes. J Clin Periodontol. 2008;35(5):385-97. PMid:18341599

Parihar AS, Katoch V, Rajguru SA, Rajpoot N, Singh P, Wakhle S. Periodontal disease: A possible risk factor for adverse pregnancy outcome. J Int Oral Health. 2015;7(7):137-42. PMid:26229389

Jeremias F, Silva SR, Valsecki AJ, Tagliaferro EP, Rosell FL. Self-perception and oral health status in pregnant women. Odontol Clin Cient. 2010;9:359-63.

Kornman KS, Loesche WJ. The subgingival microbial flora during pregnancy. J Periodontal Res. 1980;15(2):111-22. PMid:6103927

Han YW, Shen T, Chung P, Buhimschi IA, Buhimschi CS. Uncultivated bacteria as etiologic agents of intra-amniotic inflammation leading to preterm birth. J Clin Microbiol. 2009;47(1):38-47. PMid:18971361

Krishnan K, Chen T, Paster B. A practical guide to the oral microbiome and its relation to health and disease. Oral Dis. 2017;23(3):276-86. PMid:27219464

Carrillo-de-Albornoz A, Figuero E, Herrera D, BasconesMartinez A. Gingival changes during pregnancy: II. Influence of hormonal variations on the subgingival biofilm. J Clin Periodontol. 2010;37(3):230-40. PMid:20088983

Adriaens LM, Alessandri R, Sporri S, Lang NP, Persson GR. Does pregnancy have an impact on the subgingival microbiota? J Periodontol. 2009;80(1):72-81. PMid:19228092

Lieff S, Boggess KA, Murtha AP, Jared H, Madianos PN, Moss K, et al. The oral conditions and pregnancy study: Periodontal status of a cohort of pregnant women. J Periodontol. 2004;75(1):116-26. PMid:15025223

Moss KL, Ruvo AT, Offenbacher S, Beck JD, Mauriello SM, White RP Jr. Third molars and progression of periodontal pathology during pregnancy. J Oral Maxillofac Surg. 2007;65(6):1065-9. PMid:17517287

Offenbacher S, Boggess KA, Murtha AP, Jared HL, Lieff S, McKaig RG, et al. Progressive periodontal disease and risk of very preterm delivery. Obstet Gynecol. 2006;107(1):29-36. PMid:16394036

Lin D, Moss K, Beck JD, Hefti A, Offenbacher S. Persistently high levels of periodontal pathogens associated with preterm pregnancy outcome. J Periodontol. 2007;78(5):833e41. PMid:17470016

Madianos PN, Bobetsis GA, Kinane DF. Is periodontitis associated with an increased risk of coronary heart disease and preterm and/or low birth weight births? J Clin Periodontol. 2002;29(Suppl 3):22-36. PMid:12787204

Davenport ES, Williams CE, Sterne JA, Murad S, Sivapathasundram V, Curtis MA. Maternal periodontal disease and preterm low birthweight: Case-control study. J Dent Res. 2002;81(5):313-8. PMid:12097443

Figuero E, Carrillo-de-Albornoz A, Herrera D, Bascones A. Gingival changes during pregnancy: I. Influence of hormonal variations on clinical and immunological parameters. J Clin Periodontol. 2010;37(3):220-9. PMid:20070862

Andrukhov O, Ulm C, Reischl H, Nguyen PQ, Matejka M, Rausch-Fan X. Serum cytokine levels in periodontitis patients in relation to the bacterial load. J Periodontol. 2011;82:885-92. PMid:21138356

Corsalini M, Di Venere D, Sportelli P, Magazzino D, Ripa C, Cantatore F, et al. Evaluation of prosthetic quality and masticatory efficiency in patients with total removable prosthesis: Study of 12 cases. Oral Implantol (Rome). 2018;11(4):230-49.

Corsalini M, Di Venere D, Rapone B, Stefanach G, Laforgia A, Pettini F. Evidence of signs and symptoms of Craniomandibular Disorders in Fibromyalgia patients. Open Dent J. 2017;11:91-8. PMid:28357002

Di Venere D, Nardi GM, Lacarbonara V, Laforgia A, Stefanachi G, Corsalini M, et al. Early mandibular canine-lateral incisor transposition: Case report. Oral Implantol (Rome). 2017;10(2):181-9. PMid:29876043

Di Venere D, Pettini F, Nardi GM, Laforgia A, Stefanachi G, Notaro V, et al. Correlation between parodontal indexes and orthodontic retainers: prospective study in a group of 16 patients. Oral Implantol (Rome). 2017;10(1):78-86. PMid:28757939

Grassi FR, Rapone B, Catanzaro FS, Corsalini M, Kalemaj Z. Effectiveness of computer-assisted anesthetic delivery system (STA™) in dental implant surgery: A prospective study. Oral Implantol (Rome). 2017;10(4):381-9. PMid:29682255

Di Venere D, Corsalini M, Nardi GM, Laforgia A, Grassi FR, Rapone B, et al. Obstructive site localization in patients with obstructive sleep apnea syndrome: A comparison between otolaryngologic data and cephalometric values. Oral Implantol (Rome). 2017;10(3):295-310. PMid:29285333

Rapone B, Nardi GM, Di Venere D, Pettini F, Grassi FR, Corsalini M. Oral hygiene in patients with oral cancer undergoing chemotherapy and/or radiotherapy after prosthesis rehabilitation: Protocol proposal. Oral Implantol (Rome). 2016;9(01):90-7. PMid:28280537

Di Comite M, Crincoli V, Fatone L, Ballini A, Mori G, Rapone B, et al. Quantitative analysis of defects at the dentin-post space in endodontically treated teeth. Materials. 2015;8(6):3268-83.

Rapone B, Ferrara E, Santacroce L, Cesarano F, Arazzi M, Di Liberato L, et al. Periodontal microbiological status influences the occurrence of cyclosporine‐a and tacrolimus induced gingival overgrowth. Antibiotics. 2019;8(3):124. PMid:31438651

Campanella V, Syed J, Santacroce L, Saini R, Ballini A, Inchingolo F. Oral probiotics influence oral and respiratory tract infections in pediatric population: A randomized double-blinded placebo-controlled pilot study. Eur Rev Med Pharmacol Sci. 2018;22(22):8034-41. PMid:30536353

Ballini A, Santacroce L, Cantore S, Bottalico L, Dipalma G, Vito D, et al. Probiotics improve urogenital health in women. Open Access Maced J Med Sci. 2018;6(10):1845-50. PMid:30455760

Inchingolo F, Dipalma G, Cirulli N, Cantore S, Saini RS, Altini V, et al. Microbiological results of improvement in periodontal condition by administration of oral probiotics. J Biol Regul Homeost Agents. 2018;32(5):1323-8. PMid:30334433

Ballini A, Santacroce L, Cantore S, Bottalico L, Dipalma G, Topi S, et al. Probiotics efficacy on oxidative stress values in inflammatory bowel disease: A randomized double-blinded placebo-controlled pilot study. Endocr Metab Immune Disord Drug Targets. 2019;19(3):373-81. PMid:30574857

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2020-07-14

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Rapone B, Ferrara E, Montemurro N, Converti I, Loverro M, Loverro MT, Gnoni A, Scacco S, Siculella L, Corsalini M, Di Naro E. Oral Microbiome and Preterm Birth: Correlation or Coincidence? A Narrative Review. Open Access Maced J Med Sci [Internet]. 2020 Jul. 14 [cited 2024 Apr. 25];8(F):123-32. Available from: https://oamjms.eu/index.php/mjms/article/view/4444

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