Risk of Vertical Transmission of Human Papillomavirus throughout Pregnancy: A Prospective Study

Seung Mi Lee,Sun Min Kim,Yun Hwan Kim,Yong Sang Song,Chan-Wook Park,Joong Shin Park,Errol R Norwitz,Ja Nam Koo,Ig Hwan Oh,Jeong Woo Park,Robert D Burk

doi:10.1371/journal.pone.0066368

Abstract

ObjectiveMuch controversy still exists about maternal-to-infant transmission of human papillomavirus (HPV) infection, specifically about the magnitude of the risk and the route and timing of such vertical transmission. This prospective cohort study examines the risk of vertical transmission of maternal HPV in each trimester of pregnancy.Study designOne hundred fifty three healthy pregnant women were followed longitudinally throughout pregnancy and cervical swabs obtained in each trimester and postpartum for HPV detection. Cord blood, neonatal nasopharyngeal aspirates, and placental biopsies were collected at delivery. DNA isolation, polymerase chain reaction, and hybridization were performed using the GG HPV Genotyping Chip Kit (Goodgene Inc., Seoul, Korea). Detection of HPV in neonates was defined as the presence of HPV DNA in either cord blood or neonatal nasopharyngeal aspirate.ResultsHPV DNA was detected in 14%(22/153) of healthy women in the first trimester, 18%(22/124) in the second trimester, and 10%(15/153) in the third trimester; 24%(37/153) were positive for HPV DNA on at least one occasion in pregnancy. At birth, 5.2%(8/153) of neonates were HPV DNA positive. Seven of these eight infants were born to HPV-positive mothers. Placental HPV DNA was positive in 3.3%(5/152) of cases, and all five cases were from mothers with at least one HPV-positive test. Detection of HPV DNA in neonates was associated with detection of HPV in mothers during any of the three trimesters of pregnancy.ConclusionHPV DNA was detected at birth in 5.2%(8/153) of neonates born to healthy women, and was associated with the detection of HPV in mothers during any of the three trimesters of pregnancy.

Highlights

Human papillomavirus (HPV) is a member of the papillomavirus family of viruses that infects stratified epithelium of the skin and mucous membranes
Placental HPV DNA was positive in 3.3%(5/152) of cases, and all five cases were from mothers with at least one HPV-positive test
HPV DNA was detected at birth in 5.2%(8/153) of neonates born to healthy women, and was associated with the detection of HPV in mothers during any of the three trimesters of pregnancy

Summary

Introduction

Human papillomavirus (HPV) is a member of the papillomavirus family of viruses that infects stratified epithelium of the skin and mucous membranes. It is believed that HPV infections are spread almost exclusively by sexual contact, but the epidemiologic data investigating the association between sexual behavior, oropharyngeal HPV infections and cancer (such as age at first sexual intercourse and number of lifetime oral sexual partners) are inconsistent. A considerable number of such patients report only a few lifetime sexual partners and no history of oral sexual behavior [7,8,9]. These data suggest that other routes of transmission may be involved

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