There may be complex mechanisms surrounding wound healing although pregnancy is not actually a major factor. Pregnancy is not a "disease state" but a vulnerable state. Due to factors like genetics, psycho-social well being, co-morbidities, nutrition habits, exercise, alcohol and drug use, wound healing may differ from one pregnant woman and another.

However, the most basic thought I can share with you is that maternal immune system is slightly lowered during pregnancy thereby stopping any autoimmune reaction from occurring in the pregnant woman's body. The body of the mother may sees the fetus as a foreign growth and thus, may reject it if its fighting strength is not slightly lowered. This process by the body makes the mother's body vulnerable and may be compromised in cases of wound. Primarily, the immune system is very crucial in keeping the cells healthy as it forms part of the four crucial  systems needed for wound healing.

Zinc is needed for both the growth of the child and the immune system of the mother.  Hence, a deficiency of Zinc will surely affect the immune system which will affect wound healing.

During pregnancy cardiac output doubles, with an resulting increase in peripheral blow flow. With this increased blood flow to the mother's tissues, wound healing may well be enhanced. Of course the fetus is bathed in a soup of growth factors such as IGF-1 and EGF and heals skin wounds quickly with little scar tissue.

Agree with Dr. Kimble. There is no good evidence that pregnancy will alter "normal" wound healing. However, if the pregnant women are nutrionally deprived then it is possible. Not only Zn but any kind of nutrient may affect wound healing such as vitamin A, proteins, etc.

There are evidences that pregnancy can undermine the immune system of women. Some diseases, and infections occur more frequently in pregnant women than non pregnant women. There are also evidences that pregnancy could increase occurrence of diabetes.  Therefore, even though one has not read any current article on wound healing in pregnant women, one could safely guess that pregnancy could interfere with would healing process.   

Hi Gazi

Pregnancy is associated with elevated levels of estrogen, and estrogen has been implicated in negatively influencing wound healing. Wang SB et al, 2011 first suggested that estrogen negatively regulates epithelial wound healing (see The FASEB Journal, 2011; 26 (4): 1506 DOI: 10.1096/fj.11-198036). And a study published in the April 2012 issue of the (Federation of American Societies for Experimental Biology) FASEB Journal, by Karsten G et al of University of California, provided the first evidence that Estrogen is responsible for slow wound healing in women. (See www.sciencedaily.com/releases/2012/04/120402094341.htm ).

WHO reported as high as 80%  of pregnant mothers suffering from zinc deficiency, especially in the last two trimesters. Deficiency in Zinc also negatively affects healing. Zinc is not only enclosing antioxidants that shield healing cells from free radicals, but it is also essential to the proper function of the immune system. (See http://www.advancedtissue.com/wound-care-expecting-mother-concerns-precautions/ But this phenomena can only affect wound healing in women with poor nutrition.

Therefore, it is possible that pregnancy may negatively affect wound healing. But how significant can the delay influence our clinical management of pregnant women?

Dear Mairiga,

Being a dentist I need to know the very basic outcome of post extraction wound healing during pregnancy in case of emergency minor oral surgery.

Thanks.

there is no evidence that pregnancy alter or affect the wound healing however if the nutritional status is affected and anemia or malnutrition supervenes it may result in delayed wound healing for the mother.....however for the fetus there is an evidence for scar less wound healing that occurs for up to 24 weeks of gestation due to many factors ...thanks alot

Hi Gazi,

The healing process in pregnancy is the same as for those who are not. The blood vessels in the socket liberate platelets soon after an extraction; which facilitate blood clot formation. This clot takes a few hours to start getting organized and is the most important component of the extraction recovery. Once the blood clot is firmly organized, the remodeling of bone commences. After a week or so, the osteoblasts (bone forming cells) start laying down the bone, which then helps in the closure of the socket.

But how long it takes to heal completely depends on many factors e.g Health and nutritional status of the patient, type of extraction, health of the tooth, and presence of any coexisting-infection. So, not only pregnancy, many other factors may influence the healing process.

Hormonal changes associated with pregnancy make gums to be more succulent sometimes leading to gum infections. Periodontal problems occur in this period due to plaque which is present around the teeth. Therefore, possibility of longer healing time may be possible, but not absolute.

Also, it is good to know that some authorities avoid tooth extraction in first and second trimester, but obviously not because of delay in wound healing. see; http://www.identalhub.com/dental-tooth-extraction-during-pregnancy-884.aspx

There may be complex mechanisms surrounding wound healing during pregnancy. Wound healing may differ from one pregnant woman and another depending on factors like genetics, co morbidities, nutritional status, exercise, alcohol and drug use.

Pregnancy is associated with elevated levels of estrogen, and estrogen has been implicated in negatively influencing wound healing. Estrogen negatively regulates epithelial wound healing (Ref: The FASEB Journal, 2011; 26 (4): 1506 DOI: 10.1096/fj.11-198036).

Majorities of pregnant mothers suffer from zinc deficiency, especially in the last two trimesters (WHO). Zinc deficiency also negatively affects wound healing. Zinc is not only an antioxidants that shield healing cells from free radicals, but it is also essential to the proper function of the immune system. (Source: http://www.advancedtissue.com/wound-care-expecting-mother-concerns-precautions/).