Objectives:The present study was undertaken to study the maternal risk factors for preterm birth (PTB) and low birth weight (LBW) with a special emphasis on assessing the proportions of maternal genitourinary and periodontal infections among Indian women and their association with adverse pregnancy outcomes.Methods:A hospital-based prospective study comprising 790 pregnant women visiting the obstetrics clinic for a routine antenatal check-up was undertaken. Once recruited, all study participants underwent clinical and microbiological investigations for genitourinary infections followed by a dental check-up for the presence of periodontitis. The study participants were followed up until their delivery to record the pregnancy outcomes. Infectious and non-infectious risk factors for PTB and LBW were assessed using univariate and multivariate Cox regression analysis. Independent risk factors for PTB and LBW were reported in terms of adjusted relative risk (ARR) with the 95% confidence interval (CI).Results:Rates of PTB and LBW in the study population were 7.6% and 11.4%, respectively. Previous preterm delivery (ARR, 5.37; 95% CI, 1.5 to 19.1), periodontitis (ARR, 2.39; 95% CI, 1.1 to 4.9), Oligohydramnios (ARR, 5.23; 95% CI, 2.4 to 11.5), presence of Nugent’s intermediate vaginal flora (ARR, 2.75; 95% CI, 1.4 to 5.1), gestational diabetes mellitus (ARR, 2.91; 95% CI, 1.0 to 8.3), and maternal height <1.50 m (ARR, 2.21; 95% CI, 1.1 to 4.1) were risk factors for PTB, while periodontitis (ARR, 3.38; 95% CI, 1.6 to 6.9), gestational hypertension (ARR, 3.70; 95% CI, 1.3 to 10.8), maternal height <1.50 m (ARR, 2.66; 95% CI, 1.3 to 5.1) and genital infection during later stages of pregnancy (ARR, 2.79; 95% CI, 1.2 to 6.1) were independent risk factors for LBW.Conclusions:Our study findings underscore the need to consider screening for potential genitourinary and periodontal infections during routine antenatal care in developing countries.

Aim: There is strong evidence to suggest vertical and horizontal modes of transmission of human papilloma virus (HPV), an established etiologic agent of cervical cancer. Infants, children, and adults can acquire both high-risk and low-risk infections by birth or by close contact even though HPV is mainly transmitted sexually. A thorough review of the literature was performed to assess the possible non-sexual modes of transmission of HPV. Methods: An electronic search of databases for review articles, cross-sectional studies, cohort studies, and case reports on non-sexual modes of transmission among sexually unexposed women and children was carried out using search terms such as "human papilloma virus, HPV, transmission, horizontal transmission, vertical transmission, and fomites". Articles published between 1983 and 2015 were retrieved. Results: Epidemiological and clinical data support various non-sexual modes of transmission especially at the time of birth and by close contact. Even though the role of fomites in the transmission of HPV is not well established, HPV-DNA positivity has been reported in transvaginal ultrasound probes and colposcopes after routine disinfection. Conclusion: Awareness needs to be spread among the public about alternate modes of transmission. For a proper understanding of the exact natural history of HPV infection acquired via the non-sexual route, long-term prospective studies need to be undertaken.

Increased health promotion interventions and simple educational preventive programmes on oral self-care and disease prevention during pregnancy can go a long way in improving oral health and lessening its impact on the quality of life in this important population.