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Associations of treated and untreated human papillomavirus infection with preterm delivery and neonatal mortality: A Swedish population-based study

PLoS Medicine Jun 11, 2021

Wiik J, Nilsson S, Kärrberg C, et al. - A correlation has been seen between treatment of cervical intraepithelial neoplasia (CIN) and an increased risk of preterm delivery (PTD). In addition, Women with untreated CIN appear to be at increased risk of PTD. Researchers aimed at examining the correlation of HPV infection shortly before or during pregnancy, as well as of prior treatment for CIN, with risk of PTD and other adverse obstetric and neonatal outcomes. In this retrospective population-based register study, they analyzed data of women with singleton deliveries registered in the Swedish Medical Birth Register 1999–2016 (n = 1,044,023). They performed comparison of women with a history of exclusively normal cytology (n = 338,109) vs women with positive HPV tests (n = 2,550) or abnormal cytology (n = 11,727) within 6 months prior to conception or during the pregnancy, women treated for CIN3 before delivery (n = 23,185), and women with CIN2+ diagnosed after delivery (n = 33,760). Findings revealed an increased risk of PTD, preterm prelabor rupture of the membranes (pPROM), prelabor rupture of the membranes, and neonatal mortality in correlation with HPV infection shortly before or during pregnancy. In addition, CIN treatment is correlated with these adverse outcomes and with an even higher risk for PTD and pPROM. New evidence was generated in this work suggesting that prior treatment for CIN is linked with an elevated risk of maternal and neonatal infectious complications.

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