Salivary Proteomic Signatures in Pregnant Women With Excessive Gingival Bleeding

Objective This observational, cross‐sectional, and analytical study aimed to explore the pathophysiological mechanisms of gingivitis in pregnancy by analyzing the salivary proteomic profile according to gingival bleeding status. Materials and Methods Pregnant women at the 27th week of gestation or beyond were categorized into two groups: those with excessive gingival bleeding on probing (BOP > 50%; G1) and those without generalized gingivitis (BOP < 30%; G2). A comprehensive full‐mouth periodontal examination was performed. Unstimulated whole‐mouth saliva samples were collected and individually processed using Nano Liquid Chromatography Electron Spray Ionization Tandem Mass Spectrometry (nLC‐ESI‐MS/MS). Results Proteomic analysis identified 187 salivary proteins, with 75 shared between groups. Sixty proteins were upregulated and seven were downregulated in G1. The most upregulated were Protein S100‐A9 (16‐fold), Neutrophil Defensins 1 and 3 (7‐fold), Protein S100‐A8 (5‐fold), Beta‐2‐Microglobulin (4‐fold), and multiple immunoglobulin isoforms. Histatin‐3 was the only protein downregulated by more than 2‐fold. Gene Ontology analysis revealed significant enrichment in processes related to antimicrobial humoral response, bacterial defense mechanisms, and immune regulation, reflecting the inflammatory state. Conclusion These findings provide insights into the salivary proteomic alterations associated with generalized gingivitis in pregnancy, particularly highlighting immune and antimicrobial pathways linked to excessive gingival inflammation.