Pregnant Parents with HPV Are at Risk for Premature Birth

Woman in labor

Martinns / Getty Images

Key Takeaways

  • A study found that women infected with certain strains of HPV were significantly more likely to give birth prematurely.
  • Preterm birth increases the risk of newborn death.
  • A vaccine can prevent HPV.

Persistent human papillomavirus (HPV) is a common viral infection that often goes unnoticed. However, new research points to the idea that HPV may cause birth complications. A recent study found that women infected with strains HPV 16 or HPV 18 between the first and third trimester were three times as likely to experience preterm birth.

Premature birth remains a leading cause of newborn death, so it is important to reduce any factors that could contribute to early delivery.

Fortunately, HPV is preventable. A safe and effective vaccine can be administered before a person becomes sexually active, and it will protect the person against the virus.

Kelly Culwell, MD

HPV is so common that nearly every sexually active person will have an infection with HPV at some point.

— Kelly Culwell, MD

What Is HPV?

HPV is the most common sexually transmitted infection. "HPV is so common that nearly every sexually active person will have an infection with HPV at some point," says Kelly Culwell, MD, a fellowship-trained OB/GYN who specializes in women's health and contraceptive research.

There are more than 100 different strains of HPV, most of which are undetectable and resolve on their own. However, a few strains can cause genital warts while others can cause cervical cancer. "Nearly all cervical cancers are caused by infections with one of the 'high risk' strains," notes Dr. Culwell. "The most common are HPV 16 and 18."

Study Details

The study, published by the Journal of the American Medical Association (JAMA), examined vaginal samples from pregnant people in the first and third trimesters. Those who were infected with HPV 16 or 18 were three times as likely to have preterm births than those who were not infected.

Some of the preterm births occurred spontaneously, while others were scheduled based on medical needs. The researchers found that HPV infection had a similar effect on the risk of preterm birth whether or not the participants had a history of abnormal pap tests.

This was the first study to link HPV with adverse pregnancy outcomes. Previous research has shown an association between preterm birth and certain procedures done to treat precancerous cells (like cone biopsy or LEEP). "This most recent study highlights that the cause may be the persistent HPV infection rather than previous procedures," says Dr. Calwell.

The researchers call for further studies investigating the relationship between HPV vaccination status and preterm birth.

Complications of Giving Birth with an STI

Having a sexually transmitted infection at the time of birth may cause problems for your baby. For example, chlamydia infection may cause blindness in a newborn and herpes can cause meningitis.

As of now, pregnant people are not often screened for HPV during the gestational period. An active HPV infection may pass from the pregnant person to their newborn, but an inactive infection was not previously thought to be problematic.

This study brings to light new complications caused by HPV infection. We now know that HPV increases the risk of preterm birth, whether spontaneous or planned.

If you are concerned about your HPV status while pregnant, talk to your healthcare provider.

Preventing HPV

HPV may lead to cervical cancer or cause genital warts. You can prevent HPV by getting vaccinated.

Peace Nwegbo-Banks, MD

The quadrivalent HPV vaccine confers protection against wart-causing strains (6 and 11) and the most prevalent cancer-causing genotypes (16 and 18).

— Peace Nwegbo-Banks, MD

"The quadrivalent HPV vaccine confers protection against wart-causing strains (6 and 11) and the most prevalent cancer-causing genotypes (16 and 18)," says Peace Nwegbo-Banks, MD, an OB/GYN and co-owner of Serenity Women's Health & MedSpa in Pearland, Texas.

Because HPV is so common, it is important to get vaccinated before becoming sexually active. The Centers on Disease Control and Prevention (CDC) recommends that children get vaccinated at ages 11 or 12.

Teens and young adults may also get vaccinated. After age 26, however, the CDC does not recommend vaccination because this age group has generally already been exposed. Pregnant people should not get an HPV vaccine.

What This Means For You

As this study notes, HPV significantly increases the risk of preterm birth and it is a very common STI. Preterm birth is a leading cause of newborn death, and HPV is fully preventable with vaccination. It is important to get vaccinated against HPV, ideally before becoming sexually active. If you are concerned about your HPV status, talk to your healthcare provider.

8 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Niyibizi J, Mayrand M-H, Audibert F, et al. Association between human papillomavirus infection among pregnant women and preterm birth. JAMA Network Open. 2021;4(9). doi:10.1001/jamanetworkopen.2021.25308

  2. Chawanpaiboon S, Vogel JP, Moller A-B, et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. The Lancet Global Health. 2019;7(1). doi:10.1016/s2214-109x(18)30451-0

  3. de Oliveira C, Fregnani José Humberto TG, Villa L. HPV vaccine: Updates and highlights. Acta Cytologica. 2019;63(2). doi:10.1159/000497617

  4. Office of the Commissioner. HPV (human papillomavirus). U.S. Food and Drug Administration.

  5. Miller ES, Grobman WA. The association between cervical excisional procedures, midtrimester cervical length, and preterm birthAm J Obstet Gynecol. 2014;211(3):242.e1-4. doi:10.1016/j.ajog.2014.03.004.

  6. Merali HS, Zaidi AKM, Nelson BD. Neonatal infections. The MassGeneral Hospital for Children Handbook of Pediatric Global Health. Published online September 2, 2013. doi:10.1007/978-1-4614-7918-5_9

  7. Human Papillomavirus (HPV) Vaccination: What Everyone Should Know. Centers for Disease Control and Prevention.

  8. CDC’s Advisory Committee on Immunization Practices (ACIP). HPV vaccine recommendations.

By Elisa Cinelli
Elisa is a well-known parenting writer who is passionate about providing research-based content to help parents make the best decisions for their families. She has written for well-known sites including POPSUGAR and Scary Mommy, among others.