LOW-RISK OF PERINATAL TRANSMISSION OF HUMAN-PAPILLOMAVIRUS - RESULTS FROM A PROSPECTIVE COHORT STUDY

OBJECTIVE: Our purpose was to evaluate the risk of perinatal transmiss ion of human papillomavirus. STUDY DESIGN: Pregnant women were evaluat ed at <20 weeks' and between 34 and 36 weeks' gestation for genital hu man papillomavirus by clinical and colposcopic examination and by poly merase chain reaction. Their 151 infants were evaluated at birth, 6 we eks, and 6, 12, 18, 24, and 36 months of age for detection of human pa pillomavirus deoxyribonucleic acid by polymerase chain reaction on sam ples from the mouth, external genitalia, and anus. Polymerase chain re action was performed with human papillomavirus L1 consensus primers an d hybridization to human papillomavirus types 6, 11, 16, 18, 31, 33, 3 5, 39, and 45 and to a generic probe. RESULTS: During pregnancy 112 (7 4%) of 151 women had historic, clinical, or deoxyribonucleic acid evid ence of genital human papillomavirus infection. At 479 infant visits, human papillomavirus deoxyribonucleic acid was detected from only five (1.5%) of the 335 genital, four (1.2%) of the 324 anal, and none of t he 372 oral or nasopharyngeal specimens. A positively reacting specime n was obtained from three (4%) of 80 infants born to women with human papillomavirus deoxyribonucleic acid detected at 34 weeks' gestation a nd from five (8%) of 63 born to women without human papillomavirus deo xyribonucleic acid (p = 0.47). All positive results in the infants wer e positive only with the generic probe and were preceded or followed b y negatively reacting specimens. No clinical manifestations of human p apillomavirus infection were detected in any infant. CONCLUSIONS: The isolated detection of unclassified human papillomavirus types from inf ants at only single visits may represent low-level genital or nongenit al human papillomavirus or may represent contamination. Although perin atal transmission of human papillomavirus is not ruled out by these da ta, the upper 95% confidence interval for detection of perinatal trans mission from women with any evidence of genital human papillomavirus w as only 2.8%.