Does HPV Vaccination Reduce the Risk for Preterm Birth?
BACKGROUND AND PURPOSE:
McClymont et al. (BJOG, 2022) assessed whether HPV vaccination reduced the risk of preterm birth in Denmark
Population-based retrospective cohort study
Medical Birth Registry and the National Patient Registry
Born between 1961 to 2004
Singleton delivery >22 weeks between October 2006 and December 2018
HPV vaccination status
Logistic regression was used to assess the association between HPV vaccination status and outcomes
Adjustments: Maternal age | Education | Marital status | Smoking status | Pre-pregnancy BMI | Cervical lesion and treatment history | Vaccination during pregnancy
To address age at vaccination, the authors performed a stratified analysis by vaccination before and after 17 years
Spontaneous preterm birth
In age-adjusted and fully-adjusted models, there was no difference in the odds of spontaneous preterm birth between vaccinated and unvaccinated women
Age-adjusted: Odds ratio (OR) 1.05 (95% CI, 0.99 to 1.12)
Fully-adjusted: OR 1.04 (95% CI, 0.98 to 1.10)
There was also no difference in the odds of spontaneous preterm birth in relation to time between vaccination and pregnancy
Vaccination <17 years vs unvaccinated was associated with reduced risk for preterm birth
Fully-adjusted: OR 0.87 (95% CI, 0.75 to 1.00)
This association was not present for women vaccinated at >17 years
The odds of spontaneous preterm birth were reduced among those vaccinated against HPV before the age of 17, compared to unvaccinated individuals
The authors state
It seems likely that HPV vaccination may not only reduce the incidence of cervical cancer and severe precursors, as it has previously been documented but also the risk of preterm birth related to HPV infection
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