Abstract
BackgroundStudies on HPV infection in pregnant women and HPV transmission to the child have yielded inconsistent results.MethodsTo estimate mother-to-child HPV transmission we carried out a prospective cohort study that included 66 HPV-positive and 77 HPV-negative pregnant women and their offspring attending a maternity hospital in Barcelona. To estimate HPV prevalence and genotype distribution in pregnancy we also carried out a related screening survey of cervical HPV-DNA detection among 828 pregnant women. Cervical cells from the mother were collected at pregnancy (mean of 31 weeks) and at the 6-week post-partum visit. Exfoliated cells from the mouth and external genitalia of the infants were collected around birth, at the 6-week post-partum visit, and around 3, 6, 12, and 24 months of age. All samples were tested for HPV using PCR. Associations between potential determinants of HPV infection in pregnant women and of HPV positivity in infants were also explored by logistic regression modelling.ResultsOverall cervical HPV-DNA detection in pregnant women recruited in the HPV screening survey was 6.5% (54/828). Sexual behavior-related variables, previous histories of genital warts or sexually transmitted infections, and presence of cytological abnormalities were statistically significantly and positively associated with HPV DNA detection in pregnant women recruited in the cohort. At 418 infant visits and a mean follow-up time of 14 months, 19.7% of infants born to HPV-positive mothers and 16.9% of those born to HPV-negative mothers tested HPV positive at some point during infants' follow-up. The most frequently detected genotype both in infants and mothers was HPV-16, after excluding untyped HPV infections. We found a strong and statistically significant association between mother's and child's HPV status at the 6-week post-partum visit. Thus, children of mothers' who were HPV-positive at the post-partum visit were about 5 times more likely to test HPV-positive than children of corresponding HPV-negative mothers (p = 0.02).ConclusionThis study confirms that the risk of vertical transmission of HPV genotypes is relatively low. HPV persistence in infants is a rare event. These data also indicate that vertical transmission may not be the sole source of HPV infections in infants and provides partial evidence for horizontal mother-to-child HPV transmission.
Highlights
Studies on HPV infection in pregnant women and HPV transmission to the child have yielded inconsistent results
To assess in a low-risk country the prevalence and determinants of HPV infection in pregnant women as well as perinatal transmission and persistence of HPV types, we carried out an HPV screening survey in pregnant women and a prospective study of HPV-positive and HPV-negative mothers and their infants
Since the yield of HPVpositive pregnant women was too low (4 of 42 women and 24 of 73 women from the low- and high-risk group, respectively) to adequately assess mother-to-child HPV transmission, we extended the study by carrying out an HPV screening survey among unselected pregnant women to identify and recruit additional HPV-positive subjects for the prospective cohort study
Summary
Studies on HPV infection in pregnant women and HPV transmission to the child have yielded inconsistent results. Several studies have explored whether HPVs can be vertically transmitted from mother to child by direct contact during labor, or horizontally through manipulation of the child with infected hands, bathing, towels and fomites (reviewed in [1,2]). Studies evaluating transmission of HPV from mother to infant and HPV persistence in newborns and children are conflicting and show a wide range of rates. A number of studies report HPV-DNA detection in infants born to HPV-DNA negative mothers. To assess in a low-risk country the prevalence and determinants of HPV infection in pregnant women as well as perinatal transmission and persistence of HPV types, we carried out an HPV screening survey in pregnant women and a prospective study of HPV-positive and HPV-negative mothers and their infants
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
