The impact of HPV vaccination beyond cancer prevention: effect on pregnancy outcomes

ABSTRACT

While the benefits of human papillomavirus (HPV) vaccination relating to cervical cancer prevention have been widely documented, recent published evidence is suggestive of an impact on adverse pregnancy outcomes (APOs) in vaccinated mothers and their infants, including a reduction in rates of preterm births and small for gestational age infants. In this review, we examine this evidence and the possible mechanisms by which HPV vaccination may prevent these APOs. Large-scale studies linking HPV vaccination status with birth registries are needed to confirm these results. Potential confounding factors to consider in future analyses include other risk factors for APOs, and historical changes in both the management of cervical precancerous lesions and prevention of APOs. If confirmed, these additional benefits of HPV vaccination in reducing APO rates will be of global significance, due to the substantial health, social and economic costs associated with APOs, strengthening the case for worldwide HPV immunization.

KEYWORDS:

• HPV vaccination
• adverse pregnancy outcomes
• preterm births
• small for gestational age

Disclosure of potential conflicts of interest

KC is co-principal investigator of an investigator-initiated trial of cervical screening in Australia (Compass; ACTRN12613001207707 and NCT02328872), which is conducted and funded by the VCS Foundation (VCS), a government-funded health promotion charity. She is also an investigator of Compass New Zealand (ACTRN12614000714684), which was conducted and funded by Diagnostic Medlab (DML), now Auckland District Health Board. The VCS Foundation received equipment and a funding contribution from Roche Molecular Systems and Ventana USA and DML received equipment and a funding contribution for Compass from Roche Molecular Systems. However, neither KC nor her institution on her behalf (Cancer Council NSW) receives direct funding from industry for this trial or any other project. MA was supported by the Horizon 2020 Framework Programme for Research and Innovation of the European Commission (Brussels, Belgium) through the RISCC Network (Grant/Award Number: 847845). CDW is Deputy Chairman VCS Foundation Pty Ltd, owns shares in CSL and has received Honoraria from Biogen, Merck and Seqiris and sponsorship to EOGIN from Seqirus.

Additional information

Funding

This work was supported by the Cancer Council NSW [Cancer Council NSW Scholarship]; Cancer Institute NSW [ECF181561]; National Health and Medical Research Council [APP1159491]; Horizon 2020 Programme for Research and Innovation of the European Commmission [847845].