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HPV tied to miscarriages and preterm births

(Reuters Health) – Pregnant women infected with human papillomavirus (HPV) may be at increased risk for miscarriages and preterm deliveries, a review of past research suggests.

Mothers who have HPV are almost twice as likely as those who are not infected to have their water break before babies are full-term and 50% more likely to deliver babies too early, the analysis of data from 38 previous studies found. Women with HPV are also more than twice as likely to experience a miscarriage or stillbirth.

“There are no treatments to eliminate HPV,” said senior study author Helen Trottier of the University of Montreal.

“The solution lies largely in HPV vaccination before initiation of sexual relationships,” Trottier said by email.

A vaccine to prevent HPV, a common sexually-transmitted infection that can cause cancer, has been available in the U.S. since the late 2000s.

It’s currently recommended for boys and girls at age 11 or 12, with the goal of protecting them against the virus before they become sexually active. It’s also recommended for teens and young adults who may not have been previously vaccinated, and for some adults up to age 45 who determine they can benefit after discussions with their doctor.

Many women who become pregnant today may not have received the vaccine as children or teens, either because it wasn’t available when they were younger or because their parents chose not to vaccinate them.

Most infections don’t cause symptoms and go away on their own, but the virus is still a leading cause of cancer deaths among women worldwide. It can also cause genital warts, as well as cancer of the anus, penis and throat.

While previous research has also linked HPV to preterm births, miscarriages, and other pregnancy problems, results have been of varying quality and often inconsistent, the study team notes in The Journal of Infectious Diseases.

One limitation of the current analysis is that it pooled data from many smaller studies that used a wide variety of methods to define and measure pregnancy complications.

The included studies also were not designed to prove that HPV directly causes pregnancy complications.

Still, the evidence of a link between HPV and preterm birth and premature rupture of membranes, or water breaking early, was strong and consistent, the study team concludes. The connection between HPV and other outcomes like low birth weight, miscarriages and stillbirths wasn’t as strong and the evidence was of lower quality.

There are things women can do to minimize their risk of getting HPV or experiencing pregnancy complications when they do have this infection, said Dr. Christina Chu of the Fox Chase Cancer Center in Philadelphia.

“All children and young women and men should receive HPV vaccination,” Chu, who wasn’t involved in the study, said by email.

Condoms can lower the risk, as can being in a mutually monogamous relationship, Chu said. Women of childbearing age should also get routine cervical cancer screenings and HPV tests, and seek prompt prenatal care as soon as they suspect they might be pregnant.

SOURCE: The Journal of Infectious Diseases, online February 5, 2020.

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