Objectives
Human papilloma virus (HPV) has been isolated from the trophoblastic tissue of the placenta. Recent studies suggest an association between HPV and adverse pregnancy outcomes, including pre-eclampsia. However, these studies failed to adjust for all pertinent covariates, including other urogenital infections. We sought to compare the rate of gestational hypertension outcomes in women with and without HPV infection.
Methods
We conducted a single-institution retrospective cohort study of women delivering singletons in 2013. Individual patient medical record review was undertaken. All included women had cervical cytology within three years prior to delivery. Patients were excluded if they previously underwent procedures for cervical dysplasia, excluding biopsy. Patients were considered HPV positive with high or low-grade lesions on cytology or positive HPV co-testing; patients were considered HPV negative with normal cytology or atypical cells on cytology with negative HPV co-testing. The primary outcome was a composite of gestational hypertension (gestational hypertension, mild or severe pre-eclampsia, eclampsia) at any gestational age. Secondary outcomes included individual components of the hypertension composite and delivery <34 weeks due to hypertension. Other outcomes of interest included fetal growth restriction, oligohydramnios, and placental abruption. Multivariate regression adjusted for covariates including demographic variables, diabetes, prior preterm birth, chronic hypertension and urogenital infections.
Methods
We conducted a single-institution retrospective cohort study of women delivering singletons in 2013. Individual patient medical record review was undertaken. All included women had cervical cytology within three years prior to delivery. Patients were excluded if they previously underwent procedures for cervical dysplasia, excluding biopsy. Patients were considered HPV positive with high or low-grade lesions on cytology or positive HPV co-testing; patients were considered HPV negative with normal cytology or atypical cells on cytology with negative HPV co-testing. The primary outcome was a composite of gestational hypertension (gestational hypertension, mild or severe pre-eclampsia, eclampsia) at any gestational age. Secondary outcomes included individual components of the hypertension composite and delivery <34 weeks due to hypertension. Other outcomes of interest included fetal growth restriction, oligohydramnios, and placental abruption. Multivariate regression adjusted for covariates including demographic variables, diabetes, prior preterm birth, chronic hypertension and urogenital infections.
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