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Human Papillomavirus in Newborns

Article · January 2013

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 Human Papillomavirus in Newborns
L. Conde-Ferráez1, G. Quintal Bojórquez2, M. Pérez Lopez3, R.E. Suárez Allén1, G. Ayora-Talavera1, M.R. González-Losa1.
1CIR-Biomédicas, Universidad Autónoma de Yucatán. Mexico. laura.conde@uady.mx. 2Facultad de Química, Universidad Autónoma de Yucatán; 3 Hospital General “Agustín
O’Horán” , Servicios de Salud de Yucatán. Secretaría de Salud, Mexico

INTRODUCTION Table. Variables present in 372 newborns analysed for association with HPV
positivity . P values < 0.05 are significant.
Maternal transmission of Human papillomavirus (HPV) has been described to
occur mostly during vaginal delivery in women with condyloma acuminata, Frequencies p value
which is the main risk factor associated to the development of juvenile onset Variable OR (CI)
HPV+ HPV
HPV-- (X2 test
test))
respiratory papillomatosis in the child. (1)
MODE OF DELIVERY
Other risk factors associated to vertical transmission are adolescent mother,
• Vaginal 11 153 1.29 (0.50-3.29) 0.5646193
premature rupture of membranes (PROM), cephalic presentation of the • Cesarean 11 197
product and prolonged labor. HPV transmission and prevalence in cesarean PRESENTATION
delivered neonates have been described, and some evidence have suggested • Cephalic 21 319 2.04 (0.28-42.08) 0.4841772
other routes of transmission such as transplacental or ascendant infection. (2, 3) • Other 1 31
In this work we detected HPV in cervical uterus of pregnant women at the time PROM
of delivery, and in oral mucosa of their neonates, and studied epidemiological • Yes 5 40 2.28 (0.69 - 7.06) 0.1149347
determinants associated to transmission. • No 17 310
LABOR
• Yes 13 211 0.95 (0.37 - 2.49) 0.9115685
• No 9 139
METHODS MATERNAL HISTORY OF
CONDYLOMA
4 32 2.21 (0.59 - 7.52) 0.1642377
This project was approved by the bioethical committee from the Hospital • Ever
18 318
• Never
General “Agustín O’Horán” in which the study was carried out, during 2010-
2011 in Merida Yucatan (Southeast Mexico). Patients from this public facility are CONDYLOMA AT
DELIVERY
mostly low-income native Mexican. Molecular detection of HPV was performed 3 8
• Yes 6.73 (1.29 - 31.37) 0.0023461
using universal primers and nested PCR in the Virology Laboratory from CIR- • No
19 341
Biomédicas, UADY. 0 1
• No data

MATERNAL AGE
Informed consent 3.42 (1.32 - 8.98)
• 16-19 yrs old 13 104 0.0039966
• > 20 yrs old 9 246

MOTHERS
(attending for NEONATES
(within 24hr after
delivery)
birth) DISCUSSION
HPV in neonates was not related to the mode of delivery, and therefore
Oral swab
mechanisms such as ascendant or transplacental infection might be involved. (2,3)
Interview and Cervical sample
Transmission was significantly associated to younger maternal age, and to
clinical file
Automatized DNA condyloma in the mother at delivery. Our results suggest the possible HPV
extraction transmission to newborns from HPV+ mothers in 66.6% of cases. A high
percentage of these women (68.3%) had never participated in the cervical cancer
screening and therefore, the presence of cervical lesions at the time of sampling
HPV and b-globin
PCR was unknown, and might be related to the high transmission rate.
The complete genotyping of HPV positive samples in both mothers and newborns
is underway using sequencing and specific PCR. The genotypes most frequently
Data base
Statistical found as yet are 6, 11, and 31. However, preliminary results have shown disparities
SPSS in mother-newborn genotypes. Low type concordance in mother-newborn pairs
analyses (Odds
ratio, X2 test) has been described elsewhere and have been attributed to technical issues,
presence of multiple types, dynamic of infection adquisition-clearence during
RESULTS pregnancy, and/or other contacts soon after birth. (4,5,6)
To our knowledge, this is the first study of HPV in neonates performed in Mexico.
We processed 372 mother-newborn paired samples. Mothers’ age ranged Longitudinal studies are required to investigate the clinical significance of these
between 16 to 41 years old (mean 23.4 years). Overall, HPV DNA was found in findings, and to identify transient and persistent infections in the infants.
8.9% (33/372) of the mothers’ cervical samples, and in 5.9% (22/372) of the
newborns’ oral mucosa. This could represent a mother transmission rate of
66.6%. AKNOWLEDGEMENTS:
Half of the HPV positive newborns were born by cesarean section (11/22). We thank A.E. Santamaría, M.A. Molano, J. Cámara and R. Robles for technical and logistical
support. FUNDING: SEP-Promep, Mexico
Vaginal delivery, PROM and cephalic presentation were not associated to the
presence of HPV in the newborns. The analysis is shown on the table.
Eleven out of 33 (33.33%) HPV+ mothers had condyloma at the time of delivery; REFERENCES
and 3 of their respective neonates were HPV+, representing that 27% of 1) Silverberg, M.J., Thorsen, P., Lindeberg, H., Grant, L.A., Shah, K.V. 2003. Condyloma in pregnancy is strongly predictive of juvenile-onset recurrent respiratory
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