title: Risk factors for juvenile onset recurrent respiratory papillomatosis.
abstract: BACKGROUND
  Children born to condylomatous mothers are at risk for developing juvenile onset recurrent respiratory papillomatosis (JORRP). We inquired whether the triad of vaginal delivery, being firstborn and maternal age of <20 years are also risk factors for JORRP.
  
  
  METHODS
  Data for JORRP and adult onset recurrent respiratory papillomatosis cases were obtained from questionnaires answered by patients or their parents for the Recurrent Respiratory Papillomatosis Foundation. The observed numbers of cesarean births, first order births and births to mothers <20 years old were compared with expected numbers for the same variables, which were computed by distributing the cases by year of birth and then applying to them national annual statistics for the year of birth. In addition observed and expected numbers of first order births to mothers <20 years old were compared with corresponding numbers in mothers 20 years old or older.
  
  
  RESULTS
  In JORRP cases the relationships be tween observed and expected numbers of cases were as follows: cesarean births, 4.6-fold less; first order births, 1.6-fold greater; maternal age <20 years old, 2.6-fold greater. All these differences were statistically highly significant. The observed parity effect was mediated to a large extent by maternal age. In contrast there were no significant differences between observed and expected numbers of adult onset recurrent respiratory papillomatosis cases with respect to any of the above variables.
  
  
  CONCLUSIONS
  Young primiparous mothers with condylomas are at a high risk for transmission of JORRP to their infants. The option of cesarean delivery should be discussed with a mother who has condyloma at the time of delivery.
authors.affiliation: Department of Molecular Microbiology and Immunology, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: K V
authors.initials: KV
authors.lastname: Shah
authors.forename: W F
authors.initials: WF
authors.lastname: Stern
authors.forename: F K
authors.initials: FK
authors.lastname: Shah
authors.forename: D
authors.initials: D
authors.lastname: Bishai
authors.forename: H K
authors.initials: HK
authors.lastname: Kashima
mesh_terms: D000328:Adult; D001722:Birth Order; D002585:Cesarean Section / Q000706:statistics & numerical data; D002675:Child, Preschool; D003218:Condylomata Acuminata; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data; D008423:Maternal Age; D010212:Papilloma / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012142:Respiratory Tract Neoplasms / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology