Cervical human papillomavirus deoxyribonucleic acid persists throughout pregnancy and decreases in the postpartum period

OBJECTIVE: Our goal was to determine the persistence of human papillomaviru s infection of the cervix in a prospectively evaluated cohort of pregnant w omen observed from the first trimester until after delivery. STUDY DESIGN: A group of 232 women were enrolled in the first trimester of pregnancy and had cervicovaginal lavage specimens collected for detection o f the deoxyribonucleic acid of human papillomavirus. They underwent samplin g again in the third trimester (146 patients available) and at 4 to 12 week s after delivery (83 patients available). Human papillomavirus deoxyribonuc leic acid was detected by means of the Hybrid Capture assay. RESULTS: In the first trimester of pregnancy, 31% of the patients had posit ive test results for human papillomavirus deoxyribonucleic acid, whereas 35 .6% had positive results in the third trimester (P = 1.0). A comparison of first-trimester test results with postpartum results (paired data available from 83 patients) showed a decline from 39.8% positivity to 26.5% (P = .04 ). Comparing third-trimester results with postpartum results (paired data a vailable from 74 patients) showed a decline from 35.1% to 25.7% positivity (P = .12). When specimens positive for human papillomavirus were divided be tween those containing "high cancer risk" types (9 virus types often associ ated with dysplasia or malignancy) and "low cancer risk" types (5 types usu ally found in benign lesions), similar trends were seen, although not all c omparisons were statistically significant. CONCLUSION: The increased prevalence, during pregnancy, of detectable human papillomavirus deoxyribonucleic acid, which was previously reported (Fife et al, Am J Obstet Gynecol 1996,174:1437-93), persists at a similar level t hroughout pregnancy but declines in the postpartum period. This observation is most consistent with activation of the virus by the physiologic changes of pregnancy.