Human Papillomavirus (HPV) is a common viral infection. Pregnancy does not cause HPV. Instead, this article will explore the relationship between an existing HPV infection and pregnancy, detailing how the virus is transmitted, its effects on maternal health, potential risks to the baby, and current medical management strategies.
Clarifying HPV Transmission
Human Papillomavirus is a group of over 200 viruses. HPV is primarily transmitted through skin-to-skin contact, most often during sexual activity, including vaginal, anal, or oral sex. This transmission can occur even when an infected person shows no visible symptoms, and the virus can persist in the body for many years without causing problems, making it challenging to pinpoint exactly when an infection was acquired.
Impact of HPV on Maternal Health During Pregnancy
An existing HPV infection can behave differently during pregnancy due to hormonal and immune system changes. Genital warts, caused by low-risk HPV types, may grow larger, become more numerous, or bleed during pregnancy. This increase in size is often attributed to hormonal shifts, increased blood flow, and vaginal discharge.
While pregnancy can influence the appearance of warts, it does not typically worsen the underlying HPV infection or lead to more severe disease. The altered immune response during pregnancy might favor HPV persistence or reactivation. However, most HPV infections clear spontaneously, and the cumulative incidence of HPV clearance can be similar between pregnant and non-pregnant women over time.
HPV and Risks to the Baby
The risk of HPV transmission from a pregnant individual to their baby is very low. Transmission can occur during vaginal birth, or, less frequently, through the placenta or amniotic fluid. Even if a baby does acquire HPV, their immune system often clears the virus without developing complications.
A rare but serious complication for infants is Recurrent Respiratory Papillomatosis (RRP). RRP is a condition where benign, wart-like growths develop in the baby’s airway, most commonly in the voice box (larynx). These growths can cause hoarseness, a weak cry, or difficulty breathing, potentially requiring frequent surgical removal. Despite this risk, most babies born to mothers with HPV do not develop RRP.
Medical Management of HPV in Pregnancy
Medical management of HPV during pregnancy focuses on monitoring and addressing symptoms, rather than treating the virus itself. Routine cervical cancer screening, such as Pap tests, continues during pregnancy. If abnormalities are found, further evaluation like a colposcopy may be recommended, though treatment is typically postponed until after delivery.
Treatment for genital warts is deferred during pregnancy unless they become very large, bleed excessively, or obstruct the birth canal. In such cases, surgical removal, laser therapy, or cryotherapy may be considered. A Cesarean section is rarely recommended solely to prevent HPV transmission, as it has not been shown to eliminate the risk. Open communication with healthcare providers is important for appropriate monitoring and personalized care throughout pregnancy.