Placental Human Papillomavirus Infections and Adverse Pregnancy Outcomes

Introduction Knowledge on prevalence and association of human papillomavirus (HPV) in third trimester placentae and adverse pregnancy outcomes is limited. We investigated the prevalence of placental HPV at delivery, explored urine HPV characteristics associated with placental HPV and whether placental HPV increased the risk adverse pregnancy outcomes. Methods Pregnant women were enrolled in the Scandinavian PreventADALL mother- child cohort study at midgestation. Human papillomavirus genotyping was performed on placental biopsies collected at delivery (n=587) and first-void urine at midgestation and delivery (n=556, n=214 respectively). Maternal characteristics were collected by questionnaires at gestational week 18 and 34. Adverse pregnancy outcomes were registered from chart data including hypertensive disorders of pregnancy, gestational diabetes mellitus and newborns small for gestational age. Uni- and multivariable regression models were used to investigate associations. Results Placental HPV was detected in 18/587 (3%). Twenty-eight genotypes were identified among the 214/556 (38%) with midgestational urine HPV. Seventeen of the 18 women with placental HPV were midgestational HPV positive with 89% genotype concordance. Midgestational high-risk-(HR)-HPV and high viral loads of Any- or HR-HPV were associated with placental HPV. Persisting HPV infection from midgestation to delivery was not associated with placental HPV. Adverse pregnancy outcomes were seen in 2/556 (0.4%) of women with placental HPV. Discussion In this general cohort of pregnant women, the prevalence of placental HPV was 3%, and midgestational urinary HPV 38%. High HPV viral load increased the risk for placental HPV infections. We observed no increased risk for adverse pregnancy outcomes in women with placental HPV.