High risk human papillomavirus at entry to prenatal care and risk of preeclampsia

McDonnold, Mollie; Dunn, Holly E.; Hester, Ashley; Pacheco, Luis D.; Hankins, Gary D.V.; Saade, George R.; Costantine, Maged M.

doi:10.1016/j.ajog.2013.09.040

Cited by 50 publications

(54 citation statements)

References 23 publications

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“…Twelve studies [12, 19-22, 24-30] reported the impact of HPV infection on risk of spontaneous abortion. Five studies [17, 18, 21, 23, 31] reported the risk of sPTB and 7 studies [10-12, 19-22] reported the risk of clinical pregnancy rate of ART. Eight studies [12, 17, 18, 20, 21, 23, 27, 29] reported HR-HPV infection alone and the other 10 studies [10, 11, 19, 22, 24-26, 28, 30, 31] reported indiscriminate genotype infection (HR/LR-HPV).…”

Section: Resultsmentioning

confidence: 99%

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The Risk of Human Papillomavirus Infection for Spontaneous Abortion, Spontaneous Preterm Birth, and Pregnancy Rate of Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis

Xiong

Luo

et al. 2018

Gynecol Obstet Invest

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Aims: To estimate the impact of human papillomavirus (HPV) infection on spontaneous abortion, spontaneous preterm birth (sPTB), pregnancy rate of females undergoing assisted reproductive technologies (ART), and spontaneous abortion of ART pregnancy. Methods: PubMed, Medline, Embase, and the Cochrane Library were searched until December 16, 2016. The OR or relative risk (RR) with its corresponding 95% CI were selected as effect size. Subgroup analysis of HPV genotype infection (high-risk HPV [HR-HPV] or indiscriminate genotype) was performed. Statistical analysis was conducted using STATA 12.0. Results: Eighteen studies were included. Eight studies revealed no significant association between HPV infection and spontaneous abortion (OR 1.40, 95% CI 0.56–3.50). However, subgroup analysis showed indiscriminate genotype HPV infection increased the ratio of spontaneous abortion with OR of 2.24 (95% CI 1.37–3.65), while HR-HPV infection had no significant effect (OR 0.65, 95% CI 0.21–1.98). The results indicated that HR-HPV infection was a risk for sPTB with a pooled OR of 2.84 (95% CI 1.95–4.14). HPV infection was found to be independent of the ART-based clinical pregnancy rate (RR 1.04, 95% CI 0.64–1.70) and spontaneous abortion of ART pregnancy (RR 1.47, 95% CI 0.86–2.50). Conclusions: Indiscriminate HPV genotype infection can increase the risk of spontaneous abortion and HR-HPV infection was a risk factor for sPTB. However, there was not enough evidence to indicate the association between HPV infection and pregnancy rate of ART, and spontaneous abortion of ART pregnancy. Different genotypes of HPV infection may play a discrepant role in adverse pregnancy outcomes.

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Section: Resultsmentioning

confidence: 99%

“…Five studies [12, 17, 18, 21, 23], including 3 cohort studies, one case-control study, and one cross-sectional study, with a total of 1,719 participants, reported the impact of cervical HPV infection on the risk of sPTB. All 5 studies studied HR-HPV infection.…”

Section: Resultsmentioning

confidence: 99%

The Risk of Human Papillomavirus Infection for Spontaneous Abortion, Spontaneous Preterm Birth, and Pregnancy Rate of Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis

Xiong

Luo

et al. 2018

Gynecol Obstet Invest

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“…Modern Pathology (2015Pathology ( ) 28, 1369Pathology ( -1382 doi:10.1038/modpathol.2015 published online 21 August 2015 In the immune and hormonal modulated milieu of pregnancy, viruses are well known to infect the placenta, developing fetus, and neonate. The most common and important neoplastic driver of the lower uterine tract, human papillomavirus (HPV), 1 has been detected in the uterine cervix of 15-25% of pregnant women 2-6 and a cervical HPV infection during pregnancy has been associated with a higher incidence of spontaneous abortions, 7-9 premature rupture of the membranes, 10 spontaneous preterm labor, 11,12 pre-eclampsia, 13 and placental 'villitis' not otherwise specified. 12 HPV DNA has been detected in the placenta and amniotic fluid.…”

mentioning

confidence: 99%

“…The most common and important neoplastic driver of the lower uterine tract, human papillomavirus (HPV), 1 has been detected in the uterine cervix of 15-25% of pregnant women [2][3][4][5][6] and a cervical HPV infection during pregnancy has been associated with a higher incidence of spontaneous abortions, [7][8][9] premature rupture of the membranes, 10 spontaneous preterm labor, 11,12 pre-eclampsia, 13 and placental 'villitis' not otherwise specified. 12 HPV DNA has been detected in the placenta and amniotic fluid.…”

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confidence: 99%

A clinicopathological study of episomal papillomavirus infection of the human placenta and pregnancy complications

et al. 2015

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Viral infections are known to adversely affect pregnancy, but scant attention has been given to human papilloma virus (HPV) infection. We aimed to determine the molecular and histopathological features of placental HPV infection, in association with pregnancy complications including fetal growth restriction, pre-maturity, pre-eclampsia, and diabetes. Three hundred and thirty-nine placentae were selected based on the presence or absence of pregnancy complications. Five independent methods were used to identify HPV in the placenta, namely, immunohistochemistry for L1 viral capsid, in situ hybridization to high-risk HPV DNA, PCR, western blotting, and transmission electron microscopy. Pregnancy complications and uterine cervical smear screening results were correlated with placental HPV histopathology. In this study, which was deliberately biased towards complications, HPV was found in the decidua of 75% of placentae (253/339) and was statistically associated with histological acute chorioamnionitis (P o0.05). In 14% (35/253) of the HPV positive cases, HPV L1 immunoreactivity also occurred in the villous trophoblast where it was associated with a lymphohistiocytic villitis (HPV-LHV), and was exclusively of high-risk HPV type. HPV-LHV significantly associated with fetal growth restriction, preterm delivery, and pre-eclampsia (all P o0.05). All cases of pre-eclampsia (20/20) in our cohort had high-risk placental HPV. A further 55 cases (22%, 55/253) of HPV positive placentae had minimal villous trophoblast HPV L1 immunoreactivity, but a sclerosing pauci-immune villitis, statistically associated with diabetes (49.1%, 27/55, Po 0.05). For women with placental HPV, 33% (69/207) had an HPV-related positive smear result before pregnancy compared with (9.4% 8/85) of women with HPV-negative placentae (P = 0.0001). Our findings support further investigations to determine if vaccination of women and men will improve pregnancy outcomes. Modern Pathology (2015Pathology ( ) 28, 1369Pathology ( -1382 doi:10.1038/modpathol.2015 published online 21 August 2015 In the immune and hormonal modulated milieu of pregnancy, viruses are well known to infect the placenta, developing fetus, and neonate. The most common and important neoplastic driver of the lower uterine tract, human papillomavirus (HPV), 1 has been detected in the uterine cervix of 15-25% of pregnant women 2-6 and a cervical HPV infection during pregnancy has been associated with a higher incidence of spontaneous abortions, 7-9 premature rupture of the membranes, 10 spontaneous preterm labor, 11,12 pre-eclampsia, 13 and placental 'villitis' not otherwise specified. 12 HPV DNA has been detected in the placenta and amniotic fluid. 7,11,[14][15][16][17]11,16,18,and 31 have been shown to replicate in trophoblast cell lines, [18][19][20] where HPV infection decreased trophoblast number and trophoblast-endometrial cell adhesion in vitro. 19,20 We investigated for the presence of HPV in the placenta and carried out a histopathological and molecular cross-sectional study of 339 ...

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“…The pathophysiology of the disease involves impaired trophoblast invasive, abnormal genetic polymorphism, vascular endothelial cell activation, immune tolerance by the maternal immune system and an exaggeration of a systematic inflammatory process. 1 Perturbation of the immune system is a central feature in the maternal generalized inflammatory response of preeclampsia; 2 among player microbial factors like Chlamydia pneumonia, 3 Chlamydia trachomatis, 4 Helicobacter pylori, 5 Human papillomavirus, 6 and cytokines like TNF-α, 7 IL-1, 8 IL-6, 9 IL-12, 10 IL-18, 11 and INF-γ 12 are thought to be involved in the pathogenesis of preeclampsia for a long time. 13,14 Data strongly focused on the alteration of the equilibration between TH1and TH2 lymphocytes in preeclamptic trophoblast, 15 in favor of an increase of TH1 profile with the consequence of defect in the expression of IL-2.…”

Section: Introductionmentioning

confidence: 99%

The possible role of cytomegalovirus infection and pro-inflammatory IL_2 cytokine in preeclampsia

Barzangy

Salh

Hamasaeed

et al. 2018

ZJMS

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IntroductionThe origin of preeclampsia, a hypertensive disorder unique to pregnancy is still a matter of debate and numerous theories have suggested. The pathophysiology of the disease involves impaired trophoblast invasive, abnormal genetic polymorphism, vascular endothelial cell activation, immune tolerance by the maternal immune system and an exaggeration of a systematic inflammatory process. Background and Objective: Fragmentary evidence suggests that trophoblast viral infection may play a role in placental dysfunction leading to complications like Preeclampsia. Among these, placental exposure to CMV induces an inflammatory response that precedes invasive trophoblast cell death. This study aimed to assess the frequency of anti-CMV IgG seropositivity and IL2 level in serum in patients with preeclampsia compared to normotensive control pregnant women. Methods: A total of 90 women were enrolled, of which 60 had preeclampsia and 30 normotensive pregnant women as the control. A serum sample was collected from each subject and was investigated for anti-CMV IgG serostatus and IL-2 concentration using Enzyme-Linked Immunosorbent Assay (ELISA) based kits. Results: In preeclamptic and normotensive pregnant women, 33.3% and 16.6% of the tested sera were seropositive for anti CMV IgG antibodies respectively (P = 0.136). Early onset preeclamptic women revealed a high frequency of anti-CMV seropositivity (80%) when compared with late onset Preeclampsia (20%). Cytokine assessment revealed a higher IL-2 level in preeclamptic women seropositive for anti-CMV IgG although statistically was not significant (P = 0.14), but in normotensive women, the IL-2 level was significantly higher in sera seropositive for anti-CMV IgG (P = 0.02). Conclusion: This study delineates a high frequency of anti-CMV IgG antibodies particularly those with early onset preeclampsia; with no significant difference for the IL-2 level.

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High risk human papillomavirus at entry to prenatal care and risk of preeclampsia

Cited by 50 publications

References 23 publications

The Risk of Human Papillomavirus Infection for Spontaneous Abortion, Spontaneous Preterm Birth, and Pregnancy Rate of Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis

The Risk of Human Papillomavirus Infection for Spontaneous Abortion, Spontaneous Preterm Birth, and Pregnancy Rate of Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis

A clinicopathological study of episomal papillomavirus infection of the human placenta and pregnancy complications

The possible role of cytomegalovirus infection and pro-inflammatory IL_2 cytokine in preeclampsia

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