title: Final report on exposure during pregnancy from a pregnancy registry for quadrivalent human papillomavirus vaccine.
abstract: OBJECTIVE
  To better describe the safety profile of pregnancy exposures to the qHPV vaccine by acquiring and analyzing post-marketing data on pregnancy outcomes.
  
  
  METHODS
  This is a voluntary, post-marketing prenatal vaccine exposure registry. Enrollment criteria included an identifiable patient and health care provider from the United States, France, or Canada and exposure within 1 month before the date of onset of the last menstrual period or at any time during pregnancy. Outcomes of interest were pregnancy outcomes and birth defects. Prospectively reported cases were used for rate calculations.
  
  
  RESULTS
  For the 1752 prospective reports with known outcome, 1518 (86.6%) were live births, including ten twin pregnancies. Of 1527 neonates, 1444 (94.6%) had no congenital anomalies. The overall rate of spontaneous abortion was 6.7 per 100 outcomes (95% confidence interval [CI] 5.5-8.2). The prevalence of major birth defects was 2.4 per 100 live-born neonates (95% CI 1.7-3.3). There were 12 fetal deaths (0.8 per 100 outcomes, 95% CI 0.4-1.4).
  
  
  CONCLUSIONS
  Rates of spontaneous abortions and major birth defects were not greater than the general population rates. Although no adverse signals have been identified to date, the qHPV vaccine is not recommended for use in pregnant women.
authors: Merck Research Laboratories, West Point, PA, USA. Electronic address: maryann_goss@merck.com.
authors: Mary Ann
authors: MA
authors: Goss
authors: Merck Research Laboratories, West Point, PA, USA.
authors: Fabio
authors: F
authors: Lievano
authors: Merck Research Laboratories, West Point, PA, USA.
authors: Karyn M
authors: KM
authors: Buchanan
authors: Merck Research Laboratories, West Point, PA, USA.
authors: Margaret M
authors: MM
authors: Seminack
authors: University of Washington, Department of Craniofacial Medicine, Department of Pediatrics, Seattle, WA, USA.
authors: Michael L
authors: ML
authors: Cunningham
authors: Merck Research Laboratories, West Point, PA, USA.
authors: Adrian
authors: A
authors: Dana
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D002648:Child; D000013:Congenital Abnormalities / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011358:Product Surveillance, Postmarketing; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000009:adverse effects* / Q000379:methods*; D055815:Young Adult
chemical_list: D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18
keywords: Childbirth; HPV; Pregnancy; Registry