2005, Number 6
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salud publica mex 2005; 47 (6)
The prevalence of high-risk HPV infection in pregnant women from Morelos, México.
Hernández-Girón C, Smith JS, Lorincz A, Arreola CE, Lazcano E, Hernández-Ávila M, Salmerón J
Language: Spanish
References: 26
Page: 423-429
PDF size: 157.87 Kb.
ABSTRACT
Objective. Some studies suggest the possibility that the physiological process of pregnancy modifies certain characteristics of the mother, increasing the risk of both, infection and persistence of infection with HPV. This association, however, has not been firmly established. This study seeks to determine the prevalence of oncogenic HPV infecton in a sample of pregnant Mexican women and its possible risk factors.
Material and Methods. A cross-sectional study was conducted using a sample of 274 pregnant women sought first level of care services during the year 2000 at the antenatal clinic of the Mexican Institute of Social Security (IMSS) in Cuernavaca, Morelos, Mexico. Samples of vaginal cells were obtained through self-collected specimens, for the high-risk HPV DNA test using the Hybrid Capture 2 test (HC2). A structured questionnaire was administered regarding sociodemographic, gynecologic, obstetric and sexual behavior characteristics. Results. The mean age was 25.7 years. The average time of pregnancy when the study was conducted was 6 months. The principal risk factors associated with high-risk HPV infection were: ages between 20 and 29 (OR= 2.82; CI95% 1.02–7.76)), age 30 and over (OR= 6.85,CI95% 1.22-38.2); partners having sexual relations with other partners (OR= 2.05; CI95% 1.2-3.7)); schooling less than 6 years (OR= 1.68 CI 95% 0.7-4.3); number of lifetime sexual partners › 2 (OR= 1.54 CI 95% 0.7-3.4); and current smoking (OR= 1.6 CI 95% 0.6-5.0).
Conclusions. Our findings show a higher prevalence of high-risk HPV infection in pregnant women, more than double, that reported in studies of non-pregnant women. The associated risk factors are similar to those of the non-pregnant population. Follow-up in these women is recommended in order to evaluate the persistence or regression of the infection.
REFERENCES
Einstein MH, Goldberg GL. Human papillomavirus and cervical neoplasia. Cancer Invest 2002;20(7-8):1080-5.
Franco EL, Franco ED, Ferenczy A: Cervical cancer: epidemiology, prevention and the role of human papillomavirus infection. CMAJ 2001; 164(7).
Vizcaíno A, Moreno V, Bosch F, Muñoz N, Barros X, Parkin D. International trends in the incidence of cervical cancer. Int J Cancer; 1998;75:536-45.
Dirección General de Información y Evaluación del Desempeño. Secretaría de Salud. Salud: México 2001: Cancer Cervicouterino. SSA 2002. 5. Muñoz N, Bosch F, Sanjosé S. Valadui P, Tormo J, Ascunce N et al. El virus del papiloma humano en la etiología del cáncer cervicouterino. BolOf Sanit Panam 1993;115(84):301-308.
Tay S, Jenkins D, Singer A. Natural killer cells in cervical intraepithelial neoplasia and human infection. Br J Obst Gynecol 1987;94:901-906.
Ho G, Bierman R, Beardsley L, Chang C, Burk D. Natural history of cervical papillomavirus infection in young women. N Eng J Med 1998;338:423-428.
Ley C, Bauer H, Reighold A. Determinants of HPV infections in young women. J Ntl Cancer Inst 1991;3:997-1000.
Tchabo J, Brinton L, Copeland C. Epp J. Determinants of genital human papillomaviruses infection in low-income women in Washington D.C. Sex Trans Dis 1993;20(5):279-285.
Syrjanen K. Human papillomavirus in genital carcinogenesis. Sex Trans Dis 1994;21(2):86-89.
Chang J, Scneider A, Smith E, Blettner M, Wahrendorf J, Turek L. Longitudinal study of the effects of pregnancy and other factors on detection of HPV. Gynecol Oncol 1996;60:355-362.
Smith E, Johnson S, Cripe T, Perlman S, MacGuiness G. Perinatal transmission and maternal risk of human papillomavirus infection. Cancer Detec Prev 1995;19:196-207.
Pakarian F, Kaye J, Cason J, Kell B, Jewers R, Derias N et al. Cancer associated human papillomaviruses: perinatal transmission and persistence. British J Obst & Gynaecol 1994; 101(6): 514-517.
Lorincz A. Hybrid CaptureTM method for detection of human papillomavirus DNA in clinical specimens. Papillomavirus Report 1996; 7:1-5.
Soares VR, Nieminen P, Aho M, Vesterinen E, Vaheri A, Pavoneen J: HPV DNA in unselected pregnant and non pregnant. Int J STD AIDS. 1990;1(4):276-8
Armbruster-Moraes E, Ioshimoto L, Leao E, Zugaib M. Prevalence of high-risk HPV in the lower genital tract of Brazilian gravidas. Int J Gynaecol Obstet 2000;69(3):223-27.
Hellman L, Prtichard J. Fisiología del Embarazo en Williams Obstetricia. México: Editorial Salvat, 1980.
Nobbenhuis M, Helmorhorst T, van den Brule A, Bezemer P, Voorhorst F, Meijer C. High-risk human papilloma clearance in pregnant women: trends for lower clearance during pregnancy with a catch-up postpartum. BJC 2002;87:75-80.
Arena S, Marchoni M, Ubertosi M, Frega A, Arena G, Villani C: HPV and pregnancy: diagnosis, methods, transmission and evolution. Minerva Ginecol 2002;54(3):225-37.
Fife K, Katz P, Roush J, Handy VD, Brown D, Hansell R: Cancer associated human papillomavirus types are selectively increased in the cervic of women in the first trimester of pregnancy. Am J Obstet Gynecol 1996;174:1487-93
Fife K, Katz B, Brizendine E, Brown D. Cervical HPV DNA persist through pregnancy and decreases in the postpartum period. Am J Obstet Gynecol 1999;180:1110-14.
Morrison E, Gammon M, Goldberg G, Vermund S, Burk R. Pregnancy and cervical infection with human papillomaviruses. Int J Gynecol Obstet 1996;54(2):125-30.
Eppel W, Worda C, Frigo P, Ulm M, Kucera E, Czerwenka K. Human papillomavirus in the cervix and placenta. Obstet Gynecol 2000;96(3):337-41
Kjellberg L, Hallmans G, Ahren A, Johansson R, Bergman F, Wadell G et al. Smoking, diet, pregnancy and oral contraceptive use as risk factors for cervical intra epithelial neoplasia in relation to human papillomavirus infection. BJC 2000;82(7):1332-38.
Sukvirach S, Smith J, Tunsakul S, Muñoz N, Keserarat V, Opasatian O et al. Population-based Human papillomavirus prevalence in Lampang and Songkla, Thailand. J Infec Dis 2003;187:1246-56.
Hagensee M, Slavinski J, Gaffga C, Suros J, Kissinger P, Martin D. Seroprevalence of human papillomavirus type 16 in pregnant women. Obstet Gynecol 1999;94(5):653-58.
Chang-Claude J, Schneider A, Smith E, Blettner M, Wahrendorf J, Turek L. Longitudinal study of the effects of pregnancy and other factor on detection of HPV. Gynecologic Oncology 1996;60:355-62.