Association of Cervical Cytology and HPV DNA Status During Pregnancy With Placental Abnormalities and Preterm Birth

Abstract

The clinical implications of abnormal cervical cytology during pregnancy are unclear. Therefore, we performed the present study to determine the role of cervical cytologic screening during pregnancy in association with placental abnormalities and preterm birth. A review of 2,480 cases during 11 years revealed significant correlation of reactive, infectious, atypical, and dysplastic cytologic changes during pregnancy with abnormal placental findings. Also, all but dysplastic cytologic changes were significantly associated with preterm birth. Furthermore, we observed significant association of the presence of high-risk human papillomavirus (HPV) DNA with preterm birth and placental abnormalities. These findings indicate that cervical infection of HPV is a risk factor for preterm birth and that cervical cytology is an effective tool for screening women for infection and inflammation during pregnancy and predicting pregnancy outcome.

Risks associated with viral infections during pregnancy

“…The maternal immune response can be beneficially or detrimentally affected by pregnancy, depending on the enviare beginning to identify viral infections as potential risk factors for PTB (53,(56)(57)(58). For example, Zuo et al showed that cervical HPV infection was associated with PTB (56), while others determined that genital HSV was also associated with PTB (53,59).…”

“…One case-control study identified a higher frequency of HPV in the extravillous trophoblast of women suffering from spontaneous PTB compared with women delivering at term, with no association with low-or high-risk HPV strains (18). Another retrospective study examined over 2,400 cases of pregnancy over an 11-year period and discovered that cervical infection with high-risk HPV was highly associated with abnormal placental pathology and PTB (56). The presence of adeno-associated virus (AAV) in amniotic cells was also associated with an increased risk of PTB, although the authors did not determine whether AAV DNA was present in the placenta (61).…”

A clinicopathological study of episomal papillomavirus infection of the human placenta and pregnancy complications

“…The most common and important neoplastic driver of the lower uterine tract, human papillomavirus (HPV), 1 has been detected in the uterine cervix of 15-25% of pregnant women [2][3][4][5][6] and a cervical HPV infection during pregnancy has been associated with a higher incidence of spontaneous abortions, [7][8][9] premature rupture of the membranes, 10 spontaneous preterm labor, 11,12 pre-eclampsia, 13 and placental 'villitis' not otherwise specified. 12 HPV DNA has been detected in the placenta and amniotic fluid. 7,11,[14][15][16][17] HPV strains 6,11,16,18, and 31 have been shown to replicate in trophoblast cell lines, [18][19][20] where HPV infection decreased trophoblast number and trophoblast-endometrial cell adhesion in vitro.…”

Genital Warts (Anogenital warts)

“…Among the nonsurgical treatment methods, the use of trichloroacetic acid (TCA) can be mentioned. This is a safe method which can be applied by a physician to treat small lesions during pregnancy; however, it is not very effective (16)(17)(18).…”