Association of periconceptional or pregnancy exposure of HPV vaccination and adverse pregnancy outcomes: a systematic review and meta-analysis with trial sequential analysis

Frontiers in Pharmacology

Pharmacology

Bin Song¹  Qing Chang¹  Hongyu Li¹  Xiaoli Yan¹  Ge Huang¹  Ping Yan²  Dan Wang³ 

[1] Department of Gynecology and Obstetrics, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China;null;[e-mail];

关键词: human papillomavirus;    vaccine;    pregnancy;    adverse pregnancy outcomes;    meta-analysis;   

DOI  :  10.3389/fphar.2023.1181919

 received in 2023-03-08, accepted in 2023-04-19,  发布年份 2023

来源: Frontiers

【 摘 要 】

Objective: To evaluate whether periconceptional or pregnancy exposure of human papillomavirus (HPV) vaccination would increase the risk of adverse pregnancy outcomes.Methods: The PubMed, Web of Science, Embase, the Cochrane Library of clinical trials were searched from inception to March 2023. We computed relative risk (RR) and 95% confidence intervals (CIs) and prediction intervals (PIs) regarding the association between HPV vaccination in periconceptional period or during pregnancy and the risks of adverse pregnancy outcomes by using R software Version 4.1.2 and STATA Version 12.0. A trial sequential analysis (TSA) was performed with TSA v0.9.5.10 Beta software.Results: Four randomized controlled trials (RCTs) and eight cohort studies were included in this meta-analysis. Analysis of RCTs showed that HPV vaccination in periconceptional period or during pregnancy did not increase the risks of spontaneous abortion (RR = 1.152, 95% CI: 0.909–1.460, 95% PI: 0.442–3.000), birth defects (RR = 1.171, 95% CI: 0.802–1.709, 95% PI: 0.320–4.342), stillbirth (RR = 1.053, 95% CI: 0.616–1.800, 95% PI: 0.318–3.540), preterm birth (RR = 0.940, 95% CI: 0.670–1.318) and ectopic pregnancy (RR = 0.807, 95% CI: 0.353–1.842, 95% PI: 0.128–5.335). In cohort studies, periconceptional or pregnancy exposures of HPV vaccine were not associated with the increased risk of spontaneous abortion (RR = 0.987, 95% CI: 0.854–1.140, 95% PI: 0.652–1.493), birth defects (RR = 0.960, 95% CI: 0.697–1.322, 95% PI: 0.371–2.480), stillbirth (RR = 1.033, 95% CI: 0.651–1.639, 95% PI: 0.052–21.064), small size for gestational age (SGA) (RR = 0.971, 95% CI: 0.873–1.081, 95% PI: 0.657–1.462) and preterm birth (RR = 0.977, 95% CI: 0.874–1.092, 95% PI: 0.651–1.444).Conclusion: HPV vaccine exposures in periconceptional period or during pregnancy did not increase the risks of adverse pregnancy outcomes, including spontaneous abortion, birth defects, stillbirth, SGA, preterm birth and ectopic pregnancy.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023399777.

【 授权许可】

Unknown   
Copyright © 2023 Yan, Li, Song, Huang, Chang, Wang and Yan.