The occurrence of genital types of human papillomavirus in normal pregnancy and in pregnant women with pregestational insulin dependent diabetes mellitus.

OBJECTIVE: The aim of the study was to evaluate the prevalence of human papillomavirus, both types of a low oncogenic risk (HPV 6, 11) and a type carrying a high oncogenic risk (HPV 16) in the genital tract of the pregnant patients, their venous blood, the cord blood and the oral cavities of the neonates. Normal pregnant women and pregnant women with insulin dependent diabetes mellitus (IDDM) diagnosed before pregnancy were included in the study.

DESIGN: The study group consisted of 15 pregnant women aged 22 to 32 years with IDDM diagnosed before pregnancy. The control group consisted of 30 patients aged 18 to 38 years, with normal pregnancy. The DNA of HPV types 6, 11 and 16 was studied in the discharge from the cervical canal, the maternal venous blood, the cord blood and the buccal smear obtained from the neonates. To detect of viral DNA the PCR was used.

SETTING: A university teaching hospital delivering approximately 2000 women annually.

RESULTS: Human papillomavirus (HPV) was found in 12 (26.7%) of the 45 pregnant women. Of the 15 patients with pregestational IDDM the DNA of HPV was detected in four (26.7%) of the patients. The DNA of HPV types 6 and 11 was found in three (20%) patients. The DNA of HPV type 16 was detected in one pregnant patient in the study group (6.67%). Of the 30 control patients, HPV DNA was detected in eight (26%). In two (6.6%), infection with oncogenic and non-oncogenic types of HPV was diagnosed. The DNA of HPV types 6 and 11 was found in six (20%) subjects. Of the 30 control patients, the DNA of HPV type 16 was detected in four (13.3%). The transmission of HPV from HPV-positive mother to fetus was found in 50% of cases.

CONCLUSIONS: (i) There was a similar level of occurrence of HPV infections in pregnant women with IDDM when compare with normal pregnancy. (ii) High percentage of HPV transmission from mother to neonate was determined. (iii) The cesarean section probably does not protect the neonate from HPV infection. (iv) There is a suggestion that fetus may be affected by HPV infection during intrauterine life.

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