Widespread HPV vaccination appears to have prevented thousands of premature births in Australia, and could lead听to improvements in infant health worldwide.
Women who have had HPV, the human papillomavirus that causes genital warts and cervical cancer, are at greater risk of having premature babies. This may be because the treatment for high-risk HPV infections involves removing affected cells from the cervix, which can prevent cancer but may sometimes affect the mechanical strength of the cervix.
Australia was one of the first countries to introduce a national HPV vaccination programme in 2007, offering free school-based vaccines to girls aged 12 to 13 and a catch-up programme for women aged between 18 and 26. About 80 per cent of eligible Australian girls have since received the vaccine annually, leading to a sharp decline in HPV infections, genital warts and precancerous cervical lesions.
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Now, research by Karen Canfell at the Cancer Council NSW in Australia and her colleagues suggests it has also cut rates of premature births.
Premature births have been steadily climbing in Australia for the past two decades, in line with what has happened in other developed economies, possibly due to reasons such as people having children later in life or IVF conceptions becoming more common.
Canfell and her colleagues found that the HPV vaccine seems to have curbed this rise. Using Australian birth data from 2000 to 2015, they found that women from vaccinated cohorts had 3 per cent fewer premature babies than those from unvaccinated cohorts after adjusting for the age of women and the years they gave birth.
In other words, the vaccination programme has probably prevented at least 2000 premature births in Australia since it began, says Canfell.
Follow-on benefits
Other factors may be at play, like changes in smoking habits or other behaviours that the study couldn鈥檛 account for. However, if HPV vaccination does indeed prevent premature births, it could have huge positive ramifications, says Canfell. Babies born prematurely are not only at greater risk of early complications like breathing difficulties and sudden infant death syndrome (SIDS), but problems later in life like ADHD, heart disease and diabetes.
鈥淕iven that HPV vaccination has now been widely implemented in high-income countries where effective cervical screening programmes have been established for many years, this effect has the potential to avoid adverse obstetric outcomes at a more global level,鈥� says Canfell.
In the future, we may see even bigger reductions in premature births, since the HPV vaccine was updated in 2018 to protect against a wider range of HPV strains, says Canfell. 鈥淲e expect more and more women to be protected over time,鈥� she says.
The Journal of Infectious Diseases
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