Maternal Human Papillomavirus Infection Increases the Risk of Premature Rupture of Membranes [19M

Abstract

INTRODUCTION: Our main objective was to assess the association between maternal human papillomavirus (HPV) infection and premature rupture of membranes (PROM). METHODS: We conducted a retrospective cohort study of singleton deliveries from 2010 to 2015. Women with HPV genotyping or cervical cytology results within 3 years were included. Maternal and fetal variables were abstracted from medical records. Chi-squared and logistic regression analyses were used. RESULTS: 2,153 women were included. 38.5% were HPV positive. The prevalence of PROM (term and preterm) was 3.4%. HPV infection (p=0.01), history of PROM (p < 0.001), drug use or smoking (p=0.01), and ethnicity (p=0.05) were associated with PROM. HPV infection (OR=2.07, 95%CI: 1.21-3.55) remained associated with PROM when adjusting for history of PROM, cervical conization, drug use or smoking, ethnicity, and insurance. Adjusting for these covariates, HPV infection was associated with preterm PROM (OR=2.23, 95%CI: 1.12-4.43) but not term PROM (OR: 1.87, 95%CI: 0.81-4.34). PPROM was associated with preterm delivery (OR=129.01, 95%CI: 35.59-467.66) after adjusting for HPV infection, PIH, diabetes, placenta previa, placenta abruption, cervical conization, smoking or drug use, ethnicity, and history of PROM. HPV infection was associated with preterm delivery (p=0.04) in univariate analysis, but not in multivariable analysis (p=0.14). HPV infection had a univariate association with newborn septicemia (p=0.02), respiratory distress (p=0.01), NICU admission (p=0.001), and low birth weight (p=0.03). CONCLUSION: HPV infection is associated with an increased risk of preterm PROM. Preterm delivery resulting from PPROM is associated with an increased risk of adverse neonatal outcomes, but maternal HPV infection does not independently increase this risk.