Abstract
BackgroundHuman papillomavirus (HPV) is the most prevalent genital infection, especially in young women of reproductive age. In vitro and animal model experiments provide compelling evidence of the harmful effect of HPV on pregnancy outcomes, but results from epidemiologic studies are inconclusive. We aim to determine the strength of the relationship between adverse pregnancy outcomes (APO) and HPV infection and assess its consistency across studies, by systematically reviewing the literature.MethodsThe search strategy has been developed on the basis of the PICOS framework: Population (pregnant women); Exposure (HVP infection confirmed by HPV testing); Comparator (pregnant women without HPV infection); Outcomes (miscarriage, spontaneous preterm birth, low birth weight, preterm premature rupture of membranes, pregnancy-induced hypertensive disorders and intrauterine growth restriction) and Study design (observational studies). We will search three information sources: (1) electronic databases (MEDLINE, EMBASE, and EBM Reviews databases); (2) Grey literature (Google Scholar and Web of Science conference proceedings); and (3) citing and cited articles of included studies. Two reviewers (JN, NZ) will independently and in duplicate screen identified articles, select eligible studies, and extract data. Discrepancies will be resolved by consensus and otherwise by discussion with the other authors (MHM, HT). Quality of included studies will be assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies. We will narratively synthesize extracted data whether meta-analysis is conducted or not. Meta-analysis of each outcome will be performed, and where appropriate, an average measure of association will be computed. We will use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess and grade the strength of confidence in cumulative estimate.DiscussionComprehensive and high-quality evidence of a negative effect of HPV on pregnancy outcomes might be an additional motivation for HPV vaccination. Absence of such relationship could dispel anxiety and reassure HPV-infected pregnant women and clinicians. Findings of a poor level of confidence will allow identification of current knowledge gaps on HPV-pregnancy outcome relationship that need further research.Systematic review registrationPROSPERO CRD42016033425
Highlights
Human papillomavirus (HPV) is the most prevalent genital infection, especially in young women of reproductive age
Health professionals have the task to answer questions and reassure HPV-positive women attending antenatal clinics on the risk of adverse pregnancy outcomes (APO) related to HPV infection. With this kind of inconsistent data, systematic reviews are recommended for identification, appraisal, and synthesis of evidence in order to inform policy makers and clinicians [45]
Our main objective is to assess whether HPV infection in pregnant women is associated with APO
Summary
Human papillomavirus (HPV) is the most prevalent genital infection, especially in young women of reproductive age. Human papillomavirus (HPV) is the most common sexually transmitted infection in adults [1, 2]. The lifetime probability of genital HPV acquisition is estimated to be more than 80% in both women and men by the age of 45 years [2]. The highest incidence rates occur in young adults, just after the onset of sexual activity [3]. Longitudinal studies in young women 17–24 years of age-reported incidence rates ranging from 15.7 to 29.4 HPV infections of all types per 1000 women-months [4]. Cohort studies of women in their thirties showed a lower incidence rate, between 5.2 and 13.4 HPV infections any type per 1000 women-months [4]. A smaller second peak is observed at 45 years [5, 6]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
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 call