Salivary Evaluation of Lactoferrin, Calprotectin, Flow Rate, and pH in Pregnant Women and Their Role in Oral Disease Progression: An In Vivo study

Introductions: Pregnancy induces hormonal and immunological changes that may alter salivary composition. However, the interaction between salivary biomarkers and pregnancy stage in relation to oral disease progression remains incompletely understood. Aim: This study evaluated salivary lactoferrin, calprotectin, mucin, flow rate, and pH during pregnancy and examined their associations with dental indices across gestational stages. Methods: Ninety women aged 25–30 years were enrolled in a case–control study and equally categorized as firsttrimester pregnant, third-trimester pregnant, or non-pregnant controls. Unstimulated saliva was collected for biomarker quantification using ELISA. Oral health was assessed using plaque, gingival, and calculus indices, along with DMFT and DMFS scores. Non-parametric tests, Spearman correlation, ANCOVA, and negative binomial regression with interaction terms were applied. Results: Calprotectin was significantly elevated in the first trimester, while mucin concentrations were reduced in the third trimester. Salivary pH was significantly lower in late pregnancy. Interaction analyses revealed a significant pregnancy-dependent association between mucin and plaque index, with higher mucin independently associated with increased plaque accumulation in the third trimester. Conclusions: Pregnancy modifies the relationship between salivary mucin and plaque accumulation, highlighting mucin as a gestation-dependent marker of oral health vulnerability. Enhanced oral monitoring during late pregnancy is warranted.