Skip to main content
SMFM 2024 Pregnancy Meeting Main banner
Final Program


Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared on social media
Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Poster Icons
Foundation Awardee
Foundation Awardee
No Social Media
No Social Media
Back
Q&A

Prematurity

Poster Session 4

(1179) Risk of recurrent spontaneous preterm birth among those with persistent cervical HPV infection

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

This retrospective cohort study aims to determine the risk of recurrent preterm premature rupture of membranes (PPROM) or preterm labor (PTL) among those with cervical high-risk human papillomavirus (cHPV) infection and a history of previous PPROM/PTL; and examine clinical characteristics of cHPV infection among patients with PTL/PPROM.

Study Design: Following IRB approval we performed a chart review of obstetric at Mayo Clinic Rochester or Mayo Clinic Health System, included patients with ≥ 1 spontaneous birth due to PPROM/PTL and positive cHPV testing from 5/1/2018- 12/31/2021. Demographics, cervical cytology, and placental pathology from the index and subsequent pregnancies were abstracted. cHPV persistence (testing during obstetric care) was defined as >1 pregnancy with positive cHPV testing.  

Results: Of 164 eligible patients, 54/164, 18/54, and 3/18 had one, two, and three subsequent pregnancies (Table 1). 21/75 (28%) had recurrence of PPROM/PTL which occurred in 8/32(25%) with persistent cHPV and 13/43(31%) without (p=0.57). HPV strain (16,18, or other high risk) was available for 99 patients, and 0/32 (0%) of patients with subsequent pregnancies and cHPV persistence changed strain type. Progression of CIN occurred in 9/16(56%), 5/9(56%), 1/2(50%) of those with persistent cHPV in subsequent pregnancies; 61/77(79%) in patients with no subsequent pregnancies. 53% of patients in index and subsequent pregnancies (1st 51%, 2nd 53%, 3rd 67%) underwent pre-pregnancy cervical excisional procedures. Histologic evidence of chorioamnionitis in the placenta was noted in 20/139(14%) of index pregnancies and 5/12 (42%) of subsequent pregnancies with persistent cHPV, but 0/19 patients without persistent cHPV (p=0.005).

Conclusion: High rates of PPROM/PTL recurrence, chorioamnionitis and CIN progression were noted in patients with persistent cHPV. No difference in rates of recurrent PPROM/PTL were noted in those whose cHPV testing transitioned to negative.  Study of a larger population with higher cHPV prevalence may provide more clarity.