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Their presence in the foeto\u2010placental compartment can stimulate a foetal immune\/inflammatory response characterized by the production of IgM antibodies against the pathogens and the secretion of elevated levels of inflammatory mediators, which in turn may cause miscarriage or premature birth. Moreover, infection\/inflammation may cause placental structural changes leading to pre\u2010eclampsia and impaired nutrient transport causing low birthweight. Foetal exposure may also result in tissue damage, increasing the risk for perinatal mortality\/morbidity. Finally, the elicited systemic inflammatory response may exacerbate local inflammatory responses at the foeto\u2010placental unit and further increase the risk for <jats:styled-content style=\"fixed-case\">APO<\/jats:styled-content>s.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Further investigation is still necessary to fully translate the findings of basic research into clinical studies and practice. Understanding the systemic virulence potential of the individual's oral microbiome and immune response may be a distinctly different issue from categorizing the nature of the challenge using clinical signs of <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>. Therefore, a more personalized targeted therapy could be a more predictive answer to the current \u201cone\u2010size\u2010fits\u2010all\u201d interventions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jcpe.12082","type":"journal-article","created":{"date-parts":[[2013,4,30]],"date-time":"2013-04-30T12:21:38Z","timestamp":1367324498000},"source":"Crossref","is-referenced-by-count":81,"title":["Adverse pregnancy outcomes (<scp>APO<\/scp>s) and periodontal disease: pathogenic mechanisms"],"prefix":"10.1111","volume":"40","author":[{"given":"Phoebus N.","family":"Madianos","sequence":"first","affiliation":[{"name":"Department of Periodontology School of Dentistry University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiorgos A.","family":"Bobetsis","sequence":"additional","affiliation":[{"name":"Department of Periodontology School of Dentistry University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Offenbacher","sequence":"additional","affiliation":[{"name":"Department of Periodontology University of North Carolina School of Dentistry at Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,4,30]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.4161\/viru.2.6.17719"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-12-89"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2008.11.017"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2009.11.003"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2007.060362"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dcn.2011.10.002"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2002.01349.x"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.11.067"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2006.0403"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2010.04.001"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/154405910708600212"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.05.050"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.02.026"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/molehr\/gah234"},{"key":"e_1_2_5_16_1","first-page":"47","article-title":"Periodontal disease and poor obstetrical outcome","volume":"31","author":"Carta G.","year":"2004","journal-title":"Clinical and Experimental Obstetrics and Gynecology"},{"key":"e_1_2_5_17_1","doi-asserted-by":"crossref","first-page":"4652","DOI":"10.1128\/iai.62.10.4652-4655.1994","article-title":"Effects of Escherichia coli and Porphyromonas gingivalis lipopolysaccharide on pregnancy outcome in the golden hamster","volume":"62","author":"Collins J. 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