Human Papillomavirus (HPV) is a common viral infection that affects many people globally. While primarily known for its sexual transmission, a less common but possible scenario involves the transfer of HPV from a mother to her baby. This article explores how such transmission occurs, its implications for infant health, and available preventative measures and care strategies.
How HPV Can Be Transmitted to Infants
The primary way an infant can acquire HPV from their mother is through vertical transmission during a vaginal birth. This occurs when the baby comes into direct contact with HPV-infected tissues or lesions, such as genital warts, in the mother’s birth canal. The virus is typically not transmitted through the placenta during pregnancy or through breast milk after birth.
Studies indicate that the risk of vertical transmission of HPV DNA to a newborn’s oral or genital mucosa is low, ranging from 1-5% in some cases, even when the mother tests positive for HPV. The presence of active, extensive genital warts in the birth canal may increase the likelihood of this direct contact transmission.
Health Implications for Infants
For infants who acquire HPV at birth, the main health concern is the development of Recurrent Respiratory Papillomatosis (RRP). RRP is a rare condition characterized by the growth of benign, wart-like tumors in the respiratory tract, most commonly affecting the voice box (larynx). These growths can lead to symptoms such as hoarseness or a weak cry in infants, and as they enlarge, they may cause noisy breathing or difficulty breathing.
The severity of RRP varies, and while the tumors are typically non-cancerous, they can obstruct the airway, potentially requiring ongoing medical management. Children diagnosed with RRP often need multiple surgical procedures to remove the papillomas as they tend to regrow. Most infants born to mothers with HPV do not develop RRP, and many HPV infections detected in newborns clear on their own within months.
Prevention and Care
Preventing vertical HPV transmission primarily involves preventing HPV infection in women. The HPV vaccine is a highly effective tool for this, protecting against the types of HPV most commonly associated with genital warts and RRP. Vaccinating individuals before they become sexually active can significantly reduce their risk of acquiring HPV, thereby lowering the potential for transmission to future infants.
For pregnant individuals with HPV, particularly those with active or extensive genital warts, healthcare providers may discuss options to reduce the risk of transmission. While a C-section can reduce the risk of transmission compared to vaginal delivery in specific circumstances, it is not a routine recommendation for all HPV-positive mothers due to the rarity of RRP. The decision about delivery method is made on a case-by-case basis, considering the size and location of any lesions. For infants diagnosed with RRP, care typically involves surgical removal of the papillomas to maintain a clear airway, often supplemented with other therapies to manage recurrence.