Human Papillomavirus Infection as a Possible Cause of Spontaneous Abortion and Spontaneous Preterm Delivery

Abstract

Based on the current literature, we aimed to provide an overview on Human Papillomavirus prevalence in normal pregnancies and pregnancies with adverse outcome. We conducted a systematic literature search in PubMed and Embase. Data extracted from the articles and used for analysis included HPV prevalence, pregnancy outcome, geographical location, investigated tissue types, and HPV detection methods. The overall HPV prevalence in normal full-term pregnancies was found to be 17.5% (95% CI; 17.3–17.7) for cervix, 8.3% (95% CI; 7.6–9.1) for placental tissue, 5.7% (95% CI; 5.1–6.3) for amniotic fluid, and 10.9% (95% CI; 10.1–11.7) for umbilical cord blood. Summary estimates for HPV prevalence of spontaneous abortions and spontaneous preterm deliveries, in cervix (spontaneous abortions: 24.5%, and preterm deliveries: 47%, resp.) and placenta (spontaneous abortions: 24.9%, and preterm deliveries: 50%, resp.), were identified to be higher compared to normal full-term pregnancies (P < 0.05 and P < 0.0001). Great variation in HPV prevalence was observed between study populations of different geographical locations. This review demonstrates an association between spontaneous abortion, spontaneous preterm delivery, and the presence of HPV in both the cervix and the placenta. However, a reliable conclusion is difficult to draw due to the limited number of studies conducted on material from pregnancies with adverse outcome and the risk of residual confounding.

The Risk of Human Papillomavirus Infection for Spontaneous Abortion, Spontaneous Preterm Birth, and Pregnancy Rate of Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis

“…In placental and aborted tissues, the infection rate was slightly lower, with a summary estimate of 8.3% (95% CI 7.6–9.1). Correspondingly, the prevalence of HPV was significantly higher in the cervix and placental and aborted tissue of women who underwent spontaneous abortions [7]. Although the prevalence of HPV was significantly different in normal pregnancies and the spontaneous abortion group, our results based on 5 cohort studies and 3 case-control studies indicated that there was no significant association between HPV infection and spontaneous abortion (OR 1.40; 95% CI 0.56–3.50).…”

“…In normal full-term pregnancy, prevalence of HPV was reported to vary between 2.2 and 75% in the cervical tissue, with a summary estimate of 17.5% [7]. In placental and aborted tissues, the infection rate was slightly lower, with a summary estimate of 8.3% (95% CI 7.6–9.1).…”

“…Additionally, the authors reported that 27.3% of HPV-positive women were found to have repetitive abortions, whereas this rate was only 17.4% in HPV-negative women [6]. A systematic review showed that the prevalence of HPV was significantly higher in the cervix of women who had spontaneous abortions than those who had normal full-term pregnancies (24.5 vs. 17.5%); this trend demonstrated a probable association between spontaneous abortion and the infection of HPV [7]. …”

Anogenital siğiller: İnsan papilloma virüsü, klinik bulguları ve tedavi stratejileri üzerine bir güncelleme

“…Besides, HPV can be transmitted vertically from the mother to the child during delivery which may result in neonatal and congenital, oral, or conjunctival lesions. 18,19 Anogenital warts in immunsupression: Immuncompromised individuals have a higher risk of malignant transformation and higher risk of coinfection with more than one HPV type and also have a higher viral load. AGWs are larger and more treatment resistant with higher recurrence rates.…”

Immunological tolerance, pregnancy and pre-eclampsia: the roles of semen microbes and the father1

“…Our logic would also imply a role for (potentially male-derived) microbes in miscarriages and spontaneous abortions. A microbial component to these seems well established for both miscarriages [481][482][483] and spontaneous abortions [484][485][486][487][488][489]. Of course the ability of Brucella abortus to induce abortions in domesticated livestock, especially cattle (and occasionally in humans), is well known [490][491][492]; indeed, bacteriospermia is inimical to fertilisation success [493], and nowadays it is well controlled in livestock by the use of vaccines [494] or antimicrobials [493].…”