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Infectious Diseases in Obstetrics and Gynecology
Volume 12 (2004), Issue 1, Pages 45-56
http://dx.doi.org/10.1080/10647440400009896

HPV Prevalence and Concordance in the Cervix and Oral Cavity of Pregnant Women

1Department of Epidemiology, College of Public Health, University of Iowa, Iowa, IA 52242, USA
2Department of Obstetrics/Gynecology, College of Medicine, University of Iowa, IA, USA
3Department of Biostatistics, College of Public Health, University of Iowa, IA, USA
4Veterans Affairs Medical Center, Iowa City, IA, USA
5Department of Pathology, College of Medicine, University of Iowa, IA, USA

Received 9 June 2003; Accepted 3 November 2003

Copyright © 2004 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives: This investigation examined human papillomavirus (HPV) in pregnant women in order to characterize viral prevalence, types and concordance between infection in the cervix and in the oral cavity.

Methods: A total of 577 pregnant women seeking routine obstetric care were evaluated for HPV infection in their cervix during gestation and immediately before delivery, and in the oral cavity during gestation. Male partners present during the gestational clinic visit also provided a specimen from their oral cavity. HPV assessment was performed by PCR, dot blot hybridization and DNA sequencing. A sexual and health questionnaire was completed by the pregnant women.

Results: HPV prevalence in women was 29% in the cervix and 2.4% in the oral cavity. Among those with both gestational and delivery specimens, 35% were infected at least once and 20% had infection at both intervals. At delivery, 68% of infected women had an oncogenic HPV type in the cervix. There was no type-specific HPV concordance between the two cervical specimens, nor cervical and oral results in women, nor with cervical and oral findings between partners.

Conclusion: The lack of association in HPV positivity and types between the cervix and oral cavity in these women suggests that self-inoculation is uncommon. This source of infection does not appear to be from oral contact with a current male partner, since there also was no concordance between partners. These results suggest either other modes of HPV transmission or differences in susceptibility to HPV infection or its clearance in the oral cavity and genital mucosa.