Mamas on Bedrest: Human Papilloma Virus and Preterm Labor

December 11th, 2013

Human Papilloma Virus (HPV) is in the news once again. Korean researchers have reported that high risk HPV increases the risk of premature rupture of membranes (PRM) and preterm labor in Korean women. While more studies are needed to determine exactly how HPV causes PROM and preterm labor, the researchers conclude the HPV is a serious risk to pregnant women and their babies.

These researchers knew that Human papillomavirus (HPV) is known to be more prevalent in spontaneous abortions than in elective terminations of pregnancy. Additionally, placental infection with HPV was shown to be associated with spontaneous preterm delivery. Yet to date, no one had looked at HPV prevalence and preterm births, so the researchers studied this question in Korean women.

311 women who gave birth at Korea University Medical Center were the study sample and included 45 preterm deliveries, 50 cases of premature rupture of the membranes (PROM), 21 preeclampsia cases, and 8 gestational diabetes mellitus (GDM) patients. The women were tested for HPV at 6 weeks post partum using the Hybrid Capture II system to detect high-risk (HR)-HPV infection.

The prevalence of HR-HPV infection was 14.1%. Women with HR-HPV infection had a higher incidence of PROM than those without HR-HPV and HR-HPV infection was associated with an increased risk of PROM. The prevalence of preterm delivery, preeclampsia, or GDM was not different between the women with HR-HPV and without HR-HPV.

This is an interesting and important study. While it was not clearly stated when these women became positive for HPV (seroconversion during pregnancy or “newly infected”), the implication that I read is that they were not positive prior to the study. (Would be an interesting fact to know!) In any event, by delivery, 14.1%  of these women were infected with the HPV virus and were at increased risk of having PROM. It seems that this data may be translated to women of other cultures (but again, further studies are needed to confirm the results), but the most important fact to note is that HPV infection causes an increased rate of spontaneous abortion and in pregnancies that progress, an increased rate of PROM and preterm labor.

I was not tested for HPV when I was having my kids and I am not sure if it is routinely done today as part of the first prenatal visit screening laboratories. But given this information, I think its important that clinicians screen for HPV at the first prenatal visit and at the post partum visit and that women ask about being screened if they feel that they may be at risk (and even if they are not at risk!!!).

Reference:

GeumJoon Cho, Kyung-Jin Min, Hye-Ri Hong, SuhngWook Kim, Jin-Hwa Hong, Jae-Kwan Lee, Min-Jeong Oh, HaiJoong Kim Risk “Human Papilloma Virus Infection is Associated With Premature Rupture of Membranes”  BMC Pregnancy and Childbirth 2013, 13:173  doi:10.1186/1471-2393-13-173

 

Leave a Reply

Your email address will not be published. Required fields are marked *