Risk of Human Papillomavirus (HPV) Infection and Cervical Neoplasia after Pregnancy

Parity is well established as a risk factor for cervical cancer. It is not clear, however, how pregnancy influences the natural history of HPV infection and cervical neoplasia. Our objective was to study the risk of HPV infection and cervical squamous intraepithelial lesions (SIL) after pregnancy. W...

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Veröffentlicht in:BMC Pregnancy and Childbirth 2015-10, Vol.15 (1), p.244-244, Article 244
Hauptverfasser: Trottier, Helen, Mayrand, Marie-Hélène, Baggio, Maria Luiza, Galan, Lenice, Ferenczy, Alex, Villa, Luisa L, Franco, Eduardo L
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container_title BMC Pregnancy and Childbirth
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creator Trottier, Helen
Mayrand, Marie-Hélène
Baggio, Maria Luiza
Galan, Lenice
Ferenczy, Alex
Villa, Luisa L
Franco, Eduardo L
description Parity is well established as a risk factor for cervical cancer. It is not clear, however, how pregnancy influences the natural history of HPV infection and cervical neoplasia. Our objective was to study the risk of HPV infection and cervical squamous intraepithelial lesions (SIL) after pregnancy. We used the Ludwig-McGill cohort study which includes 2462 women recruited in Sao Paulo, Brazil in 1993-97 and followed for up to 10 years. Cellular specimens were collected every 4-6 months for Pap cytology and HPV detection and genotyping by a polymerase chain reaction protocol. Study nurses recorded pregnancy occurrence during follow-up. HPV and Pap results from pregnant women were available before and after, but not during pregnancy. The associations between pregnancy and post-partum HPV infection/SIL were studied using generalized estimating equation models with logistic link. Adjusted odds ratios (OR) were estimated with empirical adjustment for confounding. We recorded 122 women with a history of pregnancy during follow-up. Of these, 29 reintegrated the cohort study after delivery. No association between HPV and pregnancy was found. A single SIL case (high grade SIL) occurred post-partum. Likewise, there was no association between pregnancy and risk of low grade SIL or any-grade SIL at the next visit (adjusted OR = 0.84, 95 % CI: 0.46-15.33) after controlling for confounders. No associations were found between pregnancy and HPV or LSIL. The single observed case of HSIL post-partum was more than would be expected based on the rate of these abnormalities among non-pregnant women. As this association was found with only one case, caution is required in the interpretation of these results.
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It is not clear, however, how pregnancy influences the natural history of HPV infection and cervical neoplasia. Our objective was to study the risk of HPV infection and cervical squamous intraepithelial lesions (SIL) after pregnancy. We used the Ludwig-McGill cohort study which includes 2462 women recruited in Sao Paulo, Brazil in 1993-97 and followed for up to 10 years. Cellular specimens were collected every 4-6 months for Pap cytology and HPV detection and genotyping by a polymerase chain reaction protocol. Study nurses recorded pregnancy occurrence during follow-up. HPV and Pap results from pregnant women were available before and after, but not during pregnancy. The associations between pregnancy and post-partum HPV infection/SIL were studied using generalized estimating equation models with logistic link. Adjusted odds ratios (OR) were estimated with empirical adjustment for confounding. We recorded 122 women with a history of pregnancy during follow-up. Of these, 29 reintegrated the cohort study after delivery. No association between HPV and pregnancy was found. A single SIL case (high grade SIL) occurred post-partum. Likewise, there was no association between pregnancy and risk of low grade SIL or any-grade SIL at the next visit (adjusted OR = 0.84, 95 % CI: 0.46-15.33) after controlling for confounders. No associations were found between pregnancy and HPV or LSIL. The single observed case of HSIL post-partum was more than would be expected based on the rate of these abnormalities among non-pregnant women. 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subjects Adult
Brazil - epidemiology
Care and treatment
Cellular biology
Cervical cancer
Deoxyribonucleic acid
DNA
Female
Follow-Up Studies
Genotype
Health aspects
Human papillomavirus
Humans
Infections
Maternal & child health
Medical research
Medicine, Experimental
Natural history
Papanicolaou Test
Papillomaviridae - genetics
Papillomaviridae - isolation & purification
Papillomavirus Infections - epidemiology
Pharmaceutical industry
Postpartum Period
Pregnancy
Pregnancy Complications, Infectious - epidemiology
Risk factors
Squamous Intraepithelial Lesions of the Cervix - epidemiology
Squamous Intraepithelial Lesions of the Cervix - pathology
Vaginal Smears
Womens health
Young Adult
title Risk of Human Papillomavirus (HPV) Infection and Cervical Neoplasia after Pregnancy
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