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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2019

Open Access 01-12-2019 | Human Papillomavirus | Research article

Peri-conceptional or pregnancy exposure of HPV vaccination and the risk of spontaneous abortion: a systematic review and meta-analysis

Authors: Jing Tan, Yi-quan Xiong, Qiao He, Yan-mei Liu, Wen Wang, Meng Chen, Kang Zou, Xing-hui Liu, Xin Sun

Published in: BMC Pregnancy and Childbirth | Issue 1/2019

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Abstract

Background

To assess whether the peri-conceptional or pregnancy exposure of human papillomavirus (HPV) vaccination would increase the risk of spontaneous abortion.

Methods

We searched PubMed, Embase, and Cochrane Central Register of Controlled Trials for clinical trials and observational studies that investigated the association between exposure of HPV vaccines (2vHPV, 4vHPV or 9vHPV) during peri-conceptional period or pregnancy and spontaneous abortion before 28 gestational weeks. We pooled data from 2vHPV, 4vHPV and 9vHPV separately. Subgroup analyses were conducted according to data sources, and raw data or adjusted data.

Results

Seven observational studies were eligible and all studies were low risk of bias. Meta-analyses suggested that 2vHPV vaccination did not increase the risk of spontaneous abortion regardless of exposure period during 90 days before last menstrual period (LMP) or pregnancy: risk ratio, 95% confidence intervals (RR, 95% CI), 1.15 (0.95–1.39), and 45 days before LMP or pregnancy: 1.28 (0.96–1.70). However, 2vHPV vaccination during Pre-45 days to LMP seemed to increase the risk of spontaneous abortion: 1.59 (1.04–2.45). The current evidence did not support the association between 4vHPV vaccination and spontaneous abortion regardless of exposure period during 45 days before LMP or pregnancy: 0.88 (0.73–1.06); and 45 days before LMP: 1.00 (0.80–1.24). Additionally, 9vHPV during within 30 days of conception also seemed to increase the risk: 2.04 (1.28–3.24).

Conclusions

The association between peri-conceptional or pregnancy exposure of HPV vaccine and spontaneous abortion is still uncertain, and additional research is warranted to assess the impact of exposure of HPV vaccination on spontaneous abortion.
Appendix
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Metadata
Title
Peri-conceptional or pregnancy exposure of HPV vaccination and the risk of spontaneous abortion: a systematic review and meta-analysis
Authors
Jing Tan
Yi-quan Xiong
Qiao He
Yan-mei Liu
Wen Wang
Meng Chen
Kang Zou
Xing-hui Liu
Xin Sun
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2019
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-019-2425-1

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