Maternal human papillomavirus infection during pregnancy and preterm delivery, a mother–child cohort study in Norway and Sweden
Artikel i vetenskaplig tidskrift, 2023

Introduction:
Human papillomavirus (HPV) infection is common in women of reproductive age. Infection and inflammation are leading causes for preterm delivery (PTD), but the role of HPV infection in PTD and prelabor rupture of membranes (PROM) is unclear. We aimed to explore whether HPV infection during pregnancy in general, and high-risk-HPV (HR-HPV) infection specifically, increased the risk of PTD, preterm prelabor rupture of membranes (PPROM), PROM at term, and/or chorioamnionitis.
Material and Methods:
In pregnant women, who were participating in a prospective multicenter cohort study from a general population in Norway and Sweden (PreventADALL, ClinicalTrials.gov NCT02449850), HPV DNA was analyzed in available urine samples at mid-gestation (16–22 weeks) and at delivery, and in the placenta after delivery with Seegene Anyplex II HPV28 PCR assay. The risk of PTD, PPROM, PROM, and chorioamnionitis was analyzed using unadjusted and adjusted logistic regression analyses for any 28 HPV genotypes, including 12 HR-HPV genotypes, compared with HPV-negative women. Further, subgroups of HPV (low-risk/possibly HR-HPV, HR-HPV-non-16 and HR-HPV-16), persistence of HR-HPV from mid-gestation to delivery, HR-HPV-viral load, and presence of multiple HPV infections were analyzed for the obstetric outcomes. Samples for HPV analyses were available from 950 women with singleton pregnancies (mean age 32 years) at mid-gestation and in 753 also at delivery. Results:
At mid-gestation, 40% of women were positive for any HPV and 24% for HR-HPV. Of the 950 included women, 23 had PTD (2.4%), nine had PPROM (0.9%), and six had chorioamnionitis (0.6%). Of the term pregnancies, 25% involved PROM. The frequency of PTD was higher in HR-HPV-positive women (8/231, 3.5%) than in HPV-negative women (13/573, 2.3%) at mid-gestation, but the association was not statistically significant (odds ratio 1.55; 95% confidence interval 0.63–3.78). Neither any HPV nor subgroups of HPV at mid-gestation or delivery, nor persistence of HR-HPV was significantly associated with increased risk for PTD, PPROM, PROM, or chorioamnionitis. No HPV DNA was detected in placentas of women with PTD, PPROM or chorioamnionitis.
Conclusions:
HPV infection during pregnancy was not significantly associated with increased risk for PTD, PPROM, PROM, or chorioamnionitis among women from a general population with a low incidence of adverse obstetric outcomes.

preterm birth

rupture of membranes

HPV

delivery

infections

Författare

Johanna Wiik

Göteborgs universitet

Østfold Hospital

Sahlgrenska universitetssjukhuset

Magdalena R. Værnesbranden

Universitetet i Oslo

Østfold Hospital

Christine M. Jonassen

Østfold Hospital

Norwegian Institute of Public Health

Anne Cathrine Staff

Oslo universitetssykehus

Universitetet i Oslo

Karin C.L. Carlsen

Universitetet i Oslo

Oslo universitetssykehus

Berit Granum

Norwegian Institute of Public Health

Guttorm Haugen

Oslo universitetssykehus

Universitetet i Oslo

Gunilla Hedlin

Karolinska universitetssjukhuset

Karolinska Institutet

Katarina Hilde

Oslo universitetssykehus

Universitetet i Oslo

Bo Jacobsson

Norwegian Institute of Public Health

Göteborgs universitet

Sahlgrenska universitetssjukhuset

Staffan Nilsson

Chalmers, Matematiska vetenskaper, Tillämpad matematik och statistik

Göteborgs universitet

Björn Nordlund

Karolinska Institutet

Karolinska universitetssjukhuset

Anbjørg Rangberg

Østfold Hospital

Eva Maria Rehbinder

Universitetet i Oslo

Oslo universitetssykehus

Verena Sengpiel

Sahlgrenska universitetssjukhuset

Göteborgs universitet

Håvard Skjerven

Oslo universitetssykehus

Universitetet i Oslo

Birgitte K. Sundet

Universitetet i Oslo

Oslo universitetssykehus

Cilla Söderhäll

Karolinska universitetssjukhuset

Karolinska Institutet

Riyas Vettukattil

Universitetet i Oslo

Oslo universitetssykehus

Katrine Sjøborg

Østfold Hospital

Acta Obstetricia et Gynecologica Scandinavica

0001-6349 (ISSN) 1600-0412 (eISSN)

Vol. 102 3 344-354

Ämneskategorier

Infektionsmedicin

Reproduktionsmedicin och gynekologi

DOI

10.1111/aogs.14509

PubMed

36647213

Mer information

Senast uppdaterat

2024-04-03