Association Between Maternal Human Papillomavirus Infection and Adverse Pregnancy Outcomes: Systematic Review and Meta-Analysis
Abstract Background Experimental studies provide evidence of the harmful effect of human papillomavirus (HPV) infection on pregnancy, but observational studies are inconclusive. We systematically assessed the association between HPV and adverse pregnancy outcomes. Methods We searched electronic data...
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| Veröffentlicht in: | The Journal of infectious diseases 2020-06, Vol.221 (12), p.1925-1937 |
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| container_issue | 12 |
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| container_title | The Journal of infectious diseases |
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| creator | Niyibizi, Joseph Zanré, Nadège Mayrand, Marie-Hélène Trottier, Helen |
| description | Abstract
Background
Experimental studies provide evidence of the harmful effect of human papillomavirus (HPV) infection on pregnancy, but observational studies are inconclusive. We systematically assessed the association between HPV and adverse pregnancy outcomes.
Methods
We searched electronic databases up to December 1, 2019. We included observational studies on the association between HPV and adverse pregnancy outcomes. We conducted a random-effect meta-analysis for each outcome and assessed heterogeneity between studies.
Results
From 3034 citations, we included 38 studies and quantitatively synthesized 36 studies. Human papillomavirus was significantly associated with preterm birth (age-adjusted odds ratio [aOR], 1.50; 95% confidence interval [CI], 1.19–1.88), preterm premature rupture of membranes (aOR, 1.96; 95% CI, 1.11–3.45), premature rupture of membranes (aOR, 1.42; 95% CI, 1.08–1.86), intrauterine growth restriction (aOR, 1.17; 95% CI, 1.01–1.37), low birth weight (aOR, 1.91; 95% CI, 1.33–2.76), and fetal death (aOR, 2.23; 95% CI, 1.14–4.37). No significant association was found for spontaneous abortion (aOR, 1.14; 95% CI, 0.40–3.22) and pregnancy-induced hypertensive disorders (aOR, 1.24; 95% CI, 0.80–1.92). Most of the studies were of moderate or low quality, and substantial between-studies heterogeneity remained unexplained.
Conclusions
We found a consistent and significant association between HPV and preterm birth and preterm premature rupture of membranes. Human papillomavirus may also be associated with intrauterine growth restriction, low birth weight, and fetal death, but findings are limited by suboptimal control of biases.
This meta-analysis suggests that HPV is associated with preterm birth and preterm premature rupture of membranes. Associations are also possible for other adverse pregnancy outcomes, but the potential biases and the small number of studies do not allow definitive conclusions. |
| doi_str_mv | 10.1093/infdis/jiaa054 |
| format | Article |
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Background
Experimental studies provide evidence of the harmful effect of human papillomavirus (HPV) infection on pregnancy, but observational studies are inconclusive. We systematically assessed the association between HPV and adverse pregnancy outcomes.
Methods
We searched electronic databases up to December 1, 2019. We included observational studies on the association between HPV and adverse pregnancy outcomes. We conducted a random-effect meta-analysis for each outcome and assessed heterogeneity between studies.
Results
From 3034 citations, we included 38 studies and quantitatively synthesized 36 studies. Human papillomavirus was significantly associated with preterm birth (age-adjusted odds ratio [aOR], 1.50; 95% confidence interval [CI], 1.19–1.88), preterm premature rupture of membranes (aOR, 1.96; 95% CI, 1.11–3.45), premature rupture of membranes (aOR, 1.42; 95% CI, 1.08–1.86), intrauterine growth restriction (aOR, 1.17; 95% CI, 1.01–1.37), low birth weight (aOR, 1.91; 95% CI, 1.33–2.76), and fetal death (aOR, 2.23; 95% CI, 1.14–4.37). No significant association was found for spontaneous abortion (aOR, 1.14; 95% CI, 0.40–3.22) and pregnancy-induced hypertensive disorders (aOR, 1.24; 95% CI, 0.80–1.92). Most of the studies were of moderate or low quality, and substantial between-studies heterogeneity remained unexplained.
Conclusions
We found a consistent and significant association between HPV and preterm birth and preterm premature rupture of membranes. Human papillomavirus may also be associated with intrauterine growth restriction, low birth weight, and fetal death, but findings are limited by suboptimal control of biases.
This meta-analysis suggests that HPV is associated with preterm birth and preterm premature rupture of membranes. Associations are also possible for other adverse pregnancy outcomes, but the potential biases and the small number of studies do not allow definitive conclusions.</description><identifier>ISSN: 0022-1899</identifier><identifier>EISSN: 1537-6613</identifier><identifier>DOI: 10.1093/infdis/jiaa054</identifier><identifier>PMID: 32022858</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Bias ; Birth weight ; Female ; Fetal Growth Retardation - epidemiology ; Fetal Growth Retardation - virology ; Fetal Membranes, Premature Rupture - epidemiology ; Fetal Membranes, Premature Rupture - virology ; Fetuses ; Human papillomavirus ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Low birth weight ; Meta-analysis ; Observational Studies as Topic ; Papillomaviridae - pathogenicity ; Papillomavirus Infections - complications ; Papillomavirus Infections - epidemiology ; Papillomavirus Infections - virology ; Pregnancy ; Pregnancy Complications, Infectious - epidemiology ; Pregnancy Complications, Infectious - virology ; Pregnancy Outcome ; Premature birth ; Premature Birth - epidemiology ; Premature Birth - virology ; Review ; Rupture ; Womens health</subject><ispartof>The Journal of infectious diseases, 2020-06, Vol.221 (12), p.1925-1937</ispartof><rights>The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. 2020</rights><rights>The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c452t-febf264367c9ee66269151e13fa38d25d939abced1d9c2aa414998030ecc735a3</citedby><cites>FETCH-LOGICAL-c452t-febf264367c9ee66269151e13fa38d25d939abced1d9c2aa414998030ecc735a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32022858$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Niyibizi, Joseph</creatorcontrib><creatorcontrib>Zanré, Nadège</creatorcontrib><creatorcontrib>Mayrand, Marie-Hélène</creatorcontrib><creatorcontrib>Trottier, Helen</creatorcontrib><title>Association Between Maternal Human Papillomavirus Infection and Adverse Pregnancy Outcomes: Systematic Review and Meta-Analysis</title><title>The Journal of infectious diseases</title><addtitle>J Infect Dis</addtitle><description>Abstract
Background
Experimental studies provide evidence of the harmful effect of human papillomavirus (HPV) infection on pregnancy, but observational studies are inconclusive. We systematically assessed the association between HPV and adverse pregnancy outcomes.
Methods
We searched electronic databases up to December 1, 2019. We included observational studies on the association between HPV and adverse pregnancy outcomes. We conducted a random-effect meta-analysis for each outcome and assessed heterogeneity between studies.
Results
From 3034 citations, we included 38 studies and quantitatively synthesized 36 studies. Human papillomavirus was significantly associated with preterm birth (age-adjusted odds ratio [aOR], 1.50; 95% confidence interval [CI], 1.19–1.88), preterm premature rupture of membranes (aOR, 1.96; 95% CI, 1.11–3.45), premature rupture of membranes (aOR, 1.42; 95% CI, 1.08–1.86), intrauterine growth restriction (aOR, 1.17; 95% CI, 1.01–1.37), low birth weight (aOR, 1.91; 95% CI, 1.33–2.76), and fetal death (aOR, 2.23; 95% CI, 1.14–4.37). No significant association was found for spontaneous abortion (aOR, 1.14; 95% CI, 0.40–3.22) and pregnancy-induced hypertensive disorders (aOR, 1.24; 95% CI, 0.80–1.92). Most of the studies were of moderate or low quality, and substantial between-studies heterogeneity remained unexplained.
Conclusions
We found a consistent and significant association between HPV and preterm birth and preterm premature rupture of membranes. Human papillomavirus may also be associated with intrauterine growth restriction, low birth weight, and fetal death, but findings are limited by suboptimal control of biases.
This meta-analysis suggests that HPV is associated with preterm birth and preterm premature rupture of membranes. Associations are also possible for other adverse pregnancy outcomes, but the potential biases and the small number of studies do not allow definitive conclusions.</description><subject>Bias</subject><subject>Birth weight</subject><subject>Female</subject><subject>Fetal Growth Retardation - epidemiology</subject><subject>Fetal Growth Retardation - virology</subject><subject>Fetal Membranes, Premature Rupture - epidemiology</subject><subject>Fetal Membranes, Premature Rupture - virology</subject><subject>Fetuses</subject><subject>Human papillomavirus</subject><subject>Humans</subject><subject>Infant, Low Birth Weight</subject><subject>Infant, Newborn</subject><subject>Low birth weight</subject><subject>Meta-analysis</subject><subject>Observational Studies as Topic</subject><subject>Papillomaviridae - pathogenicity</subject><subject>Papillomavirus Infections - complications</subject><subject>Papillomavirus Infections - epidemiology</subject><subject>Papillomavirus Infections - virology</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Infectious - epidemiology</subject><subject>Pregnancy Complications, Infectious - virology</subject><subject>Pregnancy Outcome</subject><subject>Premature birth</subject><subject>Premature Birth - epidemiology</subject><subject>Premature Birth - virology</subject><subject>Review</subject><subject>Rupture</subject><subject>Womens health</subject><issn>0022-1899</issn><issn>1537-6613</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1v1DAQhiMEotvClSOyxAUOaf2ZxByQlgpopVat-Dhbs86keJXYWzvZak_963i7SwVcOM1hnnlm7LcoXjF6zKgWJ853rUsnSwdAlXxSzJgSdVlVTDwtZpRyXrJG64PiMKUlpVSKqn5eHAieO41qZsX9PKVgHYwuePIRxztETy5hxOihJ2fTAJ5cw8r1fRhg7eKUyLnv0D7w4Fsyb9cYE5LriDcevN2Qq2m0YcD0nnzbpBGH7LbkK64d3j1MXOII5TzrN8mlF8WzDvqEL_f1qPjx-dP307Py4urL-en8orRS8bHscNHxanu91YhVxSvNFEMmOhBNy1WrhYaFxZa12nIAyaTWDRUUra2FAnFUfNh5V9NiwNaiHyP0ZhXdAHFjAjjzd8e7n-YmrE3NG61klQVv94IYbidMoxlcstj34DFMyXCh8k5aSZnRN_-gyzBt_zNTUjZVo2rJM3W8o2wMKUXsHo9h1GyzNbtszT7bPPD6zyc84r_DzMC7HRCm1f9kvwCQhLNR</recordid><startdate>20200611</startdate><enddate>20200611</enddate><creator>Niyibizi, Joseph</creator><creator>Zanré, Nadège</creator><creator>Mayrand, Marie-Hélène</creator><creator>Trottier, Helen</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200611</creationdate><title>Association Between Maternal Human Papillomavirus Infection and Adverse Pregnancy Outcomes: Systematic Review and Meta-Analysis</title><author>Niyibizi, Joseph ; Zanré, Nadège ; Mayrand, Marie-Hélène ; Trottier, Helen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c452t-febf264367c9ee66269151e13fa38d25d939abced1d9c2aa414998030ecc735a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Bias</topic><topic>Birth weight</topic><topic>Female</topic><topic>Fetal Growth Retardation - epidemiology</topic><topic>Fetal Growth Retardation - virology</topic><topic>Fetal Membranes, Premature Rupture - epidemiology</topic><topic>Fetal Membranes, Premature Rupture - virology</topic><topic>Fetuses</topic><topic>Human papillomavirus</topic><topic>Humans</topic><topic>Infant, Low Birth Weight</topic><topic>Infant, Newborn</topic><topic>Low birth weight</topic><topic>Meta-analysis</topic><topic>Observational Studies as Topic</topic><topic>Papillomaviridae - pathogenicity</topic><topic>Papillomavirus Infections - complications</topic><topic>Papillomavirus Infections - epidemiology</topic><topic>Papillomavirus Infections - virology</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Infectious - epidemiology</topic><topic>Pregnancy Complications, Infectious - virology</topic><topic>Pregnancy Outcome</topic><topic>Premature birth</topic><topic>Premature Birth - epidemiology</topic><topic>Premature Birth - virology</topic><topic>Review</topic><topic>Rupture</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Niyibizi, Joseph</creatorcontrib><creatorcontrib>Zanré, Nadège</creatorcontrib><creatorcontrib>Mayrand, Marie-Hélène</creatorcontrib><creatorcontrib>Trottier, Helen</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Niyibizi, Joseph</au><au>Zanré, Nadège</au><au>Mayrand, Marie-Hélène</au><au>Trottier, Helen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association Between Maternal Human Papillomavirus Infection and Adverse Pregnancy Outcomes: Systematic Review and Meta-Analysis</atitle><jtitle>The Journal of infectious diseases</jtitle><addtitle>J Infect Dis</addtitle><date>2020-06-11</date><risdate>2020</risdate><volume>221</volume><issue>12</issue><spage>1925</spage><epage>1937</epage><pages>1925-1937</pages><issn>0022-1899</issn><eissn>1537-6613</eissn><abstract>Abstract
Background
Experimental studies provide evidence of the harmful effect of human papillomavirus (HPV) infection on pregnancy, but observational studies are inconclusive. We systematically assessed the association between HPV and adverse pregnancy outcomes.
Methods
We searched electronic databases up to December 1, 2019. We included observational studies on the association between HPV and adverse pregnancy outcomes. We conducted a random-effect meta-analysis for each outcome and assessed heterogeneity between studies.
Results
From 3034 citations, we included 38 studies and quantitatively synthesized 36 studies. Human papillomavirus was significantly associated with preterm birth (age-adjusted odds ratio [aOR], 1.50; 95% confidence interval [CI], 1.19–1.88), preterm premature rupture of membranes (aOR, 1.96; 95% CI, 1.11–3.45), premature rupture of membranes (aOR, 1.42; 95% CI, 1.08–1.86), intrauterine growth restriction (aOR, 1.17; 95% CI, 1.01–1.37), low birth weight (aOR, 1.91; 95% CI, 1.33–2.76), and fetal death (aOR, 2.23; 95% CI, 1.14–4.37). No significant association was found for spontaneous abortion (aOR, 1.14; 95% CI, 0.40–3.22) and pregnancy-induced hypertensive disorders (aOR, 1.24; 95% CI, 0.80–1.92). Most of the studies were of moderate or low quality, and substantial between-studies heterogeneity remained unexplained.
Conclusions
We found a consistent and significant association between HPV and preterm birth and preterm premature rupture of membranes. Human papillomavirus may also be associated with intrauterine growth restriction, low birth weight, and fetal death, but findings are limited by suboptimal control of biases.
This meta-analysis suggests that HPV is associated with preterm birth and preterm premature rupture of membranes. Associations are also possible for other adverse pregnancy outcomes, but the potential biases and the small number of studies do not allow definitive conclusions.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>32022858</pmid><doi>10.1093/infdis/jiaa054</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Bias Birth weight Female Fetal Growth Retardation - epidemiology Fetal Growth Retardation - virology Fetal Membranes, Premature Rupture - epidemiology Fetal Membranes, Premature Rupture - virology Fetuses Human papillomavirus Humans Infant, Low Birth Weight Infant, Newborn Low birth weight Meta-analysis Observational Studies as Topic Papillomaviridae - pathogenicity Papillomavirus Infections - complications Papillomavirus Infections - epidemiology Papillomavirus Infections - virology Pregnancy Pregnancy Complications, Infectious - epidemiology Pregnancy Complications, Infectious - virology Pregnancy Outcome Premature birth Premature Birth - epidemiology Premature Birth - virology Review Rupture Womens health |
| title | Association Between Maternal Human Papillomavirus Infection and Adverse Pregnancy Outcomes: Systematic Review and Meta-Analysis |
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