Maternal Human Papillomavirus Infection and Offspring Neurodevelopmental Disorders

QJM. 2024 Oct 24:hcae207. doi: 10.1093/qjmed/hcae207. Online ahead of print.

Abstract

Background: Human papillomavirus (HPV) infection can lead to multiple comorbidities in women, including mental health problems. However, few studies have examined the association between maternal HPV infection and risk of neurodevelopmental disorders in their offspring.

Aim: We aimed to investigate the association between maternal HPV infection and risk of attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) among their offspring.

Design and methods: Data from the Taiwan National Health Insurance Research Database were used for analysis. Offspring of mothers with HPV infection were identified as the index group, and a demographic-matched group (offspring of mothers without HPV infection) was selected as the controls. The primary outcome was risk of ADHD or ASD. Cox regression models with multiple adjustments were used to estimate hazard ratios (HRs) with 95% of confidence intervals (CIs).

Results: We included 7,762 individuals in the index group and 31,048 in the control group. After adjusting for potential confounding factors, the index group had a higher risk of ADHD (HR: 1.39, 95% CI: 1.15-1.67) than the controls. Importantly, the risk remained significance when HPV infection was diagnosed either before (HR: 1.29, 95% CI: 1.05-1.59) or during pregnancy (HR: 1.79, 95% CI: 1.28-2.51). No increased risk of ASD was identified in the index group compared to the control group.

Conclusions: This study highlights the importance of preventing and treating HPV infection during and before pregnancy. Clinicians should be aware of the association between maternal HPV infection and ADHD in their offspring.

Keywords: ADHD; ASD; HPV infection; mother; offspring.