Currently, human papillomavirus (HPV) research focuses on HPV infection in adults and sexual transmission. Data on HPV infection in children are slowly becoming available. It is a matter of debate whether mother-to-child transmission of HPV is an important infection route and whether children born to HPV-positive mothers are at a higher risk of HPV infection compared with children born to HPV-negative mothers. The objective of this meta-analysis is to summarize the published literature on the extent to which genital HPV infection is vertically transmitted from mother to child. Medline, Web of Science, and CINAHL were searched for eligible reports published before January 2011. Differences in the risk of HPV infection between newborns from HPV-positive and HPV-negative mothers were pooled using a random-effects model. Twenty eligible studies, including 3128 women/children pairs, fulfilled the selection criteria. High heterogeneity could be found (I=96%). The overall estimated risk difference was 33% (95% confidence interval: 22-44%). On restricting to high-risk HPV-positive mothers only (n=4; women=231), the difference in risk was 45% (95% confidence interval: 33-56%). The heterogeneity was found to be low (I=15%). This meta-analysis indicates a significantly higher risk for children born to HPV-positive mothers to become HPV positive themselves. Plausible explanations include vertical transmission of HPV during pregnancy and/or birth or a higher infection rate during early nursing from mother to child. More research is required to gain an insight into the precise mode of transmission and the clinical effects of infection on the child.

ObjectiveTo assess the effect of structured counselling on women's contraceptive decisions and to evaluate gynaecologists’ perceptions of comprehensive contraceptive counselling.MethodsBelgian women (18–40 years old) who were considering using a combined hormonal contraceptive (CHC) were counselled by their gynaecologists about available CHCs (combined oral contraceptive [COC], transdermal patch, vaginal ring), using a comprehensive leaflet. Patients and gynaecologists completed questionnaires that gathered information on the woman's pre- and post-counselling contraceptive choice, her perceptions, and the reasons behind her post-counselling decision.ResultsThe gynaecologists (N = 121) enrolled 1801 eligible women. Nearly all women (94%) were able to choose a method after counselling (53%, 5%, and 27% chose the COC, the patch, and the ring, respectively). Counselling made many women (39%) select a different method: patch use increased from 3% to 5% (p < 0.0001); ring use tripled (from 9% to 27%, p < 0.0001). Women who were undecided before counselling most often opted for the method their gynaecologist recommended, irrespective of counselling.ConclusionCounselling allows most women to select a contraceptive method; a sizeable proportion of them decide on a method different from the one they initially had in mind. Gynaecologists’ preferences influenced the contraceptive choices of women who were initially undecided regarding the method to use.

Women with FGM requesting clitoral reconstruction might primarily be looking to improve their sexual life, to recover their identity and to reduce pain. Surgery may not always be the right answer. Thorough counselling that includes medical, psychological and sexual advice is therefore necessary as part of a multidisciplinary approach.

Human papillomavirus (HPV) vaccination has been reimbursed in Belgium since 2007 for girls (12-15 years), extended to girls up to 18 years in 2008. This study assesses the trend of HPV 16/18 infections in women less than 25 years of age participating in opportunistic cervical cancer screening. A significant reduction in the prevalence of HPV 16 [relative risk (RR)=0.61, 95% confidence interval=0.39-0.95] and a nonsignificant reduction in HPV 18 (RR=0.65, 95% confidence interval=0.29-1.48) was found in the youngest group (15-19 years). The prevalences in the older age group did not change significantly. These findings show the early effects of HPV vaccination and confirm the effectiveness of immunization in a real-life setting.

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