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gingivalis have been linked to preterm birth, stillbirth, and placental inflammation via hematogenous spread and systemic immune activation24,43 Another study involving 40 women with mixed term pregnancies (25% preterm) found no shift in saliva microbiome throughout pregnancy 2

Discussion Since the COVID-19 pandemic, the prevalence of substance use, including tobacco products, marijuana, opioids, and alcohol, has been increasing, especially among men of reproductive age 28,29