title: Rate of vertical transmission of human papillomavirus from mothers to infants: relationship between infection rate and mode of delivery.
abstract: BACKGROUND
  In contrast to consistent epidemiologic evidence of the role of sexual transmission of human papillomavirus (HPV) in adults, various routes may be related to HPV infection in infants. We have assessed the extent of HPV infection during the perinatal period, and the relationship between mode of delivery and vertical transmission.
  
  
  RESULTS
  A total of 291 pregnant women over 36 weeks of gestation were enrolled with informed consent. Exfoliative cells were collected from maternal cervix and neonatal buccal mucosa. HPV infection and genotypes were determined with an HPV DNA chip, which can recognise 24 types. The HPV-positive neonates were re-evaluated 6 months after birth to identify the presence of persistent infection. HPV DNA was detected in 18.9 % (55/291) of pregnant women and 3.4 % (10/291) of neonates. Maternal infection was associated with abnormal cytology (p = 0.007) and primiparity (p = 0.015). The infected neonates were all born to HPV-positive mothers. The rate of vertical transmission was estimated at 18.2 % (10/55) which was positively correlated with maternal multiple HPV infection (p = 0.003) and vaginal delivery (p = 0.050), but not with labour duration and premature rupture of membranes. The rate of concordance of genotype was 100 % in mother-neonate pairs with vertical transmission. The neonatal HPV DNAs found at birth were all cleared at 6 months after delivery.
  
  
  CONCLUSIONS
  Vertical transmission of HPV DNA from HPV infected mother to the neonate increased when the infant was delivered through an infected cervix. However, the absence of persistent infection in infants at 6 months after delivery may suggest temporary inoculation rather than true vertical infection.
authors.affiliation: Comprehensive Gynecological Cancer Center, CHA Bundang Medical Center, CHA University, College of Medicine, Bundang, South Korea.
authors.forename: Hyun
authors.initials: H
authors.lastname: Park
authors.forename: Si Won
authors.initials: SW
authors.lastname: Lee
authors.forename: In Ho
authors.initials: IH
authors.lastname: Lee
authors.forename: Hyun Mee
authors.initials: HM
authors.lastname: Ryu
authors.forename: A Reum
authors.initials: AR
authors.lastname: Cho
authors.forename: Young Soon
authors.initials: YS
authors.lastname: Kang
authors.forename: Sung Ran
authors.initials: SR
authors.lastname: Hong
authors.forename: Sung Soon
authors.initials: SS
authors.lastname: Kim
authors.forename: Seok Ju
authors.initials: SJ
authors.lastname: Seong
authors.forename: Son Moon
authors.initials: SM
authors.lastname: Shin
authors.forename: Tae Jin
authors.initials: TJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000821:virology; D005260:Female; D005838:Genotype; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D009061:Mouth Mucosa / Q000821:virology; D020411:Oligonucleotide Array Sequence Analysis / Q000379:methods; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000635:transmission*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D011446:Prospective Studies