Good news for pregnant women with vaginal HPV evidence:


Pregnant women who test positive for the human papillomavirus (HPV) often wonder whether they can infect their baby before or during birth. A Canadian study provides new insights into this: In a few cases, the newborns tested positive for HPV, with the virus no longer being detectable from the 6th month of life.

dr Helen Trottier from the Université de Montréal and her team investigated how high the risk of HPV transmission from the pregnant woman to her child is – and whether the virus remains detectable in the baby in the first six months of life.

Over 1,000 pregnant women and their newborns tested for HPV

Between 2010 and 2016, the research team recruited pregnant women over the age of 18 as part of the HERITAGE study. The participants took a vaginal swab themselves in the first trimester of pregnancy (up to the 14th week). If this tested positive for the virus genetic material in the laboratory, the so-called HPV DNA test was repeated in the third trimester of pregnancy.

At the end of the delivery, further samples (vaginal swab, placenta, amniotic sac) were collected and tested from all women. The medical staff also took swabs from the conjunctiva, mouth, throat and genitals of the children of HPV-positive mothers – at birth and at the age of 3 and 6 months.

About every 4th pregnant woman and every 14th newborn tested positive for HPV

Overall, the research team evaluated samples from 1,050 participants and their babies. In 422 pregnant women (40.3%), the vaginal swab was HPV positive. Of the HPV-positive women, 280 (66.4%) had at least one high-risk genotype. Multiple HPV types were detectable in 190 (45.0%). HPV viruses were also detected in 10.7% of the placentas. Samples from the inside of the amniotic sac were HPV positive in 3.9%.

By 3 months of age, about 7.2% of newborns tested positive for HPV DNA biopsies. The conjunctiva was most commonly affected, followed by the mouth, genitals and throat. At the age of 6 months, none of the infants who tested positive had HPV detectable anymore.

Further HPV tests planned for the children

In this study, genetic material from HPV viruses was detectable in four out of ten pregnant women in the vaginal swab. Transmission to the newborn before or during birth was significantly less common. However, the test cannot distinguish between actual infection, colonization, or contamination at birth. All HPV DNA tests at 6 months of age were negative.

dr Trottier now plans to rescreen the children for HPV over the next 5 years. In this way, the researchers want to ensure that the HPV viruses have actually been completely eliminated and are not dormant in the children’s bodies.

Despite the good results so far, Dr. Trottier the importance of HPV vaccination in young people before they become sexually active. On the one hand, timely vaccination protects against HPV-related diseases such as cervical, anogenital and oral cancer. On the other hand, an HPV infection can significantly increase the risk of premature birth.

Source: Pranamika Khayargoli et al, Human Papillomavirus Transmission and Persistence in Pregnant Women and Neonates, JAMA Pediatrics (2023). DOI: 10.1001/jamapediatrics.2023.1283

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