Department of Obstetrics and Gynecology, Østfold Hospital Trust, P.O. Box 300, Kalnes, Kalnes, 1714, Norway.
Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, P.O. Box 1702, Blindern, Oslo, 0316, Norway.
BMC Pregnancy Childbirth. 2024 Nov 19;24(1):764. doi: 10.1186/s12884-024-06958-2.
Human papillomaviruses are common in the urogenital tract amongst women of childbearing age. A few studies indicate a possible association between human papillomavirus infections in pregnancy and adverse pregnancy outcomes whilst other studies find no such association. We aimed to investigate the association between human papillomavirus infections during pregnancy and adverse pregnancy outcomes linked to placental dysfunction, including hypertensive disorders of pregnancy, gestational diabetes mellitus and newborns small for gestational age.
Pregnant women from the general population in Norway and Sweden were enrolled at the time of routine mid-gestational ultrasound examination. Urine samples collected at mid-gestation in 950 and at delivery in 753 participants, were analyzed for 28 human papillomavirus genotypes, including 12 high-risk genotypes. Participants completed electronic questionnaires at enrollment and medical records were reviewed for background characteristics and for the following adverse pregnancy outcomes: hypertensive disorders of pregnancy including gestational hypertension, preeclampsia, superimposed preeclampsia, eclampsia and Hemolysis Elevated Liver enzymes and Low Platelets (HELLP) syndrome, gestational diabetes mellitus, and newborns small for gestational age. Associations between adverse pregnancy outcomes and (a) any human papillomavirus, high-risk human papillomavirus and human papillomavirus genotype 16 infection at mid-gestation, (b) multiple genotype infections at mid-gestation, and (c) persisting infections during pregnancy were assessed with univariable and multivariable logistic regression models. Missing covariates were imputed using multiple imputation.
At mid-gestation, 40% (377/950) of women were positive for any of the 28 genotypes, 24% (231/950) for high-risk genotypes and human papillomavirus 16 was found in 6% (59/950) of the women. Hypertensive disorders of pregnancy was observed in 9% (83/950), gestational diabetes mellitus in 4% (40/950) and newborns small for gestational age in 7% (67/950). Human papillomavirus infection with any genotype, high-risk or human papillomavirus genotype 16 at mid-gestation was not associated with adverse pregnancy outcomes. No associations were found for multiple genotype infections at mid-gestation or persisting infections.
In a general population of pregnant women, we found no evidence of human papillomavirus infections during pregnancy being associated with hypertensive disorders of pregnancy, gestational diabetes mellitus, or newborns small for gestational age.
Trial registration The study is registered at ClincialTrials.gov; NCT02449850 on May 19th, 2015.
人乳头瘤病毒在育龄妇女的泌尿生殖道中很常见。一些研究表明，妊娠期间人乳头瘤病毒感染与不良妊娠结局之间可能存在关联，而其他研究则没有发现这种关联。我们旨在研究妊娠期间人乳头瘤病毒感染与胎盘功能障碍相关的不良妊娠结局之间的关联，包括妊娠高血压疾病、妊娠期糖尿病和新生儿小于胎龄儿。
挪威和瑞典的普通人群中的孕妇在常规中期超声检查时入组。950 名孕妇在中期采集尿液样本，753 名孕妇在分娩时采集尿液样本，分析了 28 种人乳头瘤病毒基因型，包括 12 种高危型。参与者在入组时完成了电子问卷，并对病历进行了回顾，以了解背景特征和以下不良妊娠结局：妊娠高血压疾病包括妊娠期高血压、子痫前期、重叠子痫前期、子痫和溶血、肝酶升高和血小板减少（HELLP）综合征、妊娠期糖尿病和新生儿小于胎龄儿。使用单变量和多变量逻辑回归模型评估了（a）任何人乳头瘤病毒、高危型人乳头瘤病毒和人乳头瘤病毒 16 感染与中期妊娠、（b）中期多重基因型感染和（c）妊娠期间持续感染与不良妊娠结局之间的关联。使用多重插补法对缺失的协变量进行了插补。
在中期妊娠时，40%（377/950）的女性检测到 28 种基因型中的任何一种，24%（231/950）的女性检测到高危型，6%（59/950）的女性检测到人乳头瘤病毒 16。妊娠高血压疾病的发生率为 9%（83/950），妊娠期糖尿病的发生率为 4%（40/950），新生儿小于胎龄儿的发生率为 7%（67/950）。中期妊娠时任何基因型、高危型或人乳头瘤病毒 16 感染与不良妊娠结局无关。中期多重基因型感染或持续感染也没有发现关联。
在普通孕妇人群中，我们没有发现妊娠期间人乳头瘤病毒感染与妊娠高血压疾病、妊娠期糖尿病或新生儿小于胎龄儿之间存在关联的证据。
