Irene Yang, PhD, MSN
Emory University’s Nell Hodgson Woodruff School of Nursing
Dr. Irene Yang is a postdoctoral research fellow at Emory University’s Nell Hodgson Woodruff School of Nursing. Her research interests have been shaped by her clinical experience as a maternal/newborn nurse. Her research thus far has included a pilot survey study examining smoking cessation and relapse challenges reported by postpartum women. Her dissertation examined psychosocial mediators of prenatal smoking status in low SES women and she is currently exploring the biological variables that shape the prenatal time period, focusing on the endocannabinoid system and the human microbiome. In addition, her postdoctoral fellowship has included hands-on experience working with a team of researchers looking at the biobehavioral determinants of the microbiome and preterm birth in black women. It is her hope that her clinical and research experiences thus far position her to conduct research that has an impact on the health behaviors of perinatal women and the improvement of pregnancy outcomes.
Periodontal disease is a public health problem, to which pregnant women and minority,low-income women are particularly susceptible. Untreated, this chronic condition is associated with a wide range of health problems including cardiovascular disease, diabetes and cancer. Almost half of all adult Americans have mild to severe periodontitis and the condition disproportionately affects racial-ethnic minorities and those in low socioeconomic populations. Emerging evidence also suggests that maternal periodontitis is associated with adverse pregnancy outcomes such as preterm birth. In addition, transmission of the oral microbiome of mothers with periodontal disease to their infants may put them at risk for future oral pathologies.
Emerging research, utilizing next generation sequencing techniques, suggests that an oral disease state may represent a shift in the overall ecological balance of microbial flora rather than simply the appearance of unique or individual pathogens. Periodontal disease represents a complex interaction between periopathogens and the host defense system. In response to microbial pathogens, host mediated destruction of periodontal tissue is caused by hyperactivity of leukocytes and generation of cytokines, eicosanoids and matrix metalloproteinases. These biomarkers of the inflammatory process can be found in the gingival crevicular fluid and whole saliva. No published research to date, however, has profiled the oral microbiome of pregnant women or considered its association with the infant icrobiome, or with immune markers of periodontal disease or pregnancy outcomes, particularly not in African American women who are most at risk for poor pregnancy outcomes.
The aims of this study are to: I) Characterize the oral microbiome in periodontal health and disease in a population of at risk, African American pregnant women; 2) identify the associations between the maternal oral microbiome, biochemical indicators of periodontal disease, and preterm birth; and 3) Characterize the oral microbiome of the infants of these mothers.
This study will use a comparative descriptive design. Two groups of women will be recruited; each group will consist of 15 women in their second trimester of pregnancy. One
group will consist of women with healthy gums and the other with clinical signs of periodontal disease. The oral gum and cavity will be visually assessed for inflammation. Plaque samples
will be collected from each woman and analyzed for the subgingival microbiome. Saliva will be collected and assayed for three biochemical markers characteristic of disease: IL-lβ, MMP-8,
and CRP. A blood sample will be collected and assayed for systemic CRP.
This study will provide new knowledge about the oral microbiome of pregnant women with healthy and diseased gingiva and the effects of specific oral microbes and community states
on oral health and pregnancy outcomes. This study will also, for the first time, examine the association between the maternal prenatal oral micro biome and the infant oral microbiome in the
first month of life. Knowledge gained from this study will provide a foundation for understanding the progression of periodontal disease in pregnant women and for understanding
how this disease might be linked to adverse pregnancy outcomes and child oral health.