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

BMC Pregnancy and Childbirth

Eduardo L. Franco⁵  Luisa L. Villa³  Alex Ferenczy¹  Lenice Galan⁶  Maria Luiza Baggio⁶  Marie-Hélène Mayrand⁴  Helen Trottier² 

[1] Department of Pathology, McGill University and Jewish General Hospital, Montreal, Canada;Sainte-Justine Hospital Research Center, Department of Social and Preventive Medicine, Université de Montréal, 3175 Côte Sainte-Catherine, Room A-830, Montreal H3T 1C5, QC, Canada;Department of Radiology and Oncology, School of Medicine, University of São Paulo, São Paulo, Brazil;Department of Obstetrics and Gynecology, Université de Montréal and CRCHUM, Montreal, Canada;Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, Canada;Ludwig Institute for Cancer Research, São Paulo, Brazil

关键词: Human papillomaviruses (HPV);    Pregnancy;    Cervical neoplasia;   

Others  :  1228389
DOI  :  10.1186/s12884-015-0675-0

 received in 2015-02-11, accepted in 2015-10-02,  发布年份 2015

【 摘 要 】

Background

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.

Methods

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.

Results

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.

Conclusions

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.

【 授权许可】

   
2015 Trottier et al.

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