Grand Rounds

HPV Vaccine and Maternal and Infant Outcomes

BACKGROUND AND PURPOSE:

Lipkind et al. (Obstet Gynecol., 2017) evaluated the impact of administering quadrivalent human papillomavirus vaccine (4vHPV) during the periconception and perinatal time periods on maternal and fetal outcomes

Retrospective, observational cohort study (2007-2013)
Pregnancy Cohort
- Periconception (2 weeks before and 2 weeks after after LMP)
- During pregnancy
- Both of the above
Control Cohort
- 4-18 months before their last menstrual period
Outcomes were
- Gestational diabetes
- Hypertensive disorders of pregnancy
- Chorioamnionitis
- Preterm birth
- Small-for-gestational-age birth
- Major structural birth defects in offspring

720 received vaccine during periconceptional period, 698 received vaccine during pregnancy and 8196 controls received vaccine
4vHPV administered during pregnancy was not associated with increased risk for adverse obstetric events or birth outcomes
When comparing vaccine exposure during pregnancy to controls
- There was no evidence of increased preterm birth (adjusted relative risk [aRR] 0.97; 95% CI 0.72-1.3)
- There was no evidence of increased major structural birth defects (2.0% vs 1.8%)
Results were similar for 4vHPV exposure during periconceptional period

Administering 4vHPV during pregnancy or periconceptional period was not associated with adverse pregnancy or birth outcomes

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