title: Vaccination against human papillomavirus--an impact on preterm delivery? Estimations based on literature review.
abstract: OBJECTIVE
  Cervical cone excision increases the risk of preterm deliveries. Vaccination against human papillomavirus 16/18 (HPV16/18) will probably prevent development of high grade cervical intraepithelial neoplasia and thereby reduce the need for cervical cone excisions. An HPV16/18 vaccination programme may therefore also prevent some preterm deliveries.
  
  
  METHODS
  We identified the parameters influencing the effect of a HPV16/18 vaccination programme on preterm deliveries, and estimated a possible range of preventable deliveries before the 37th week of pregnancy. The number of preterm deliveries prevented by HPV16/18 vaccination programme would depend on the number of preterm deliveries related to cervical cone excision (extent of the health problem), and the proportion of this health problem that could be prevented by a vaccination programme. We obtained values on the parameters used in the estimations from the scientific literature.
  
  
  RESULTS
  If 2% of childbearing women are treated with cervical cone excision, between 60 and 220 preterm deliveries/100 000 births may be related to such treatment. Close to 60% (between 35 and 128 preterm deliveries) could be prevented by an HPV16/18 vaccination programme, if the programme coverage was 90%. If 4% of women are treated with cone excision, between 70 and 257 preterm deliveries/100 000 births could be prevented.
  
  
  CONCLUSIONS
  HPV16/18 vaccination programmes may reduce the number of preterm deliveries through reducing the need for cone excision.
authors.affiliation: Department of Obstetrics and Gynecology, Oestfold Hospital Trust, Fredrikstad, Norway. xatsjo@so-hf.no
authors.forename: Katrine Dønvold
authors.initials: KD
authors.lastname: Sjøborg
authors.forename: Anne
authors.initials: A
authors.lastname: Eskild
mesh_terms: D002584:Cervix Uteri / Q000601:surgery / Q000821:virology; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D052162:Human papillomavirus 16; D052161:Human papillomavirus 18; D006801:Humans; D030361:Papillomavirus Infections / Q000517:prevention & control* / Q000601:surgery; D053918:Papillomavirus Vaccines; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control*; D002578:Uterine Cervical Dysplasia / Q000517:prevention & control* / Q000601:surgery
chemical_list: D053918:Papillomavirus Vaccines