Original research
Condyloma in pregnancy is strongly predictive of Juvenile-Onset recurrent respiratory papillomatosis

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Abstract

Objective

To assess the risk of juvenile-onset recurrent respiratory papillomatosis conferred by a maternal history of genital warts in pregnancy, and to identify additional cofactors such as the method of delivery (cesarean versus vaginal) and procedures or complications during pregnancy.

Methods

A retrospective cohort design was used to evaluate maternal and infant characteristics associated with respiratory papillomatosis among Danish births between 1974 and 1993. Using data from Danish registries, we identified 3033 births with a maternal history of genital warts during pregnancy. Fifty-seven respiratory papillomatosis cases were identified by review of medical records from ear, nose, and throat departments.

Results

Seven of every 1000 births with a maternal history of genital warts resulted in disease in the offspring, corresponding to a 231.4 (95% confidence interval 135.3, 395.9) times higher risk of disease relative to births without a maternal history of genital warts. In women with genital warts, delivery times of more than 10 hours were associated with a two-fold greater risk of disease. Cesarean delivery was not found to be protective against respiratory papillomatosis, and no other procedures or complications during pregnancy were observed to increase the risk of respiratory papillomatosis.

Conclusion

A maternal history of genital warts in pregnancy is the strongest risk factor for respiratory papillomatosis in the child. Future studies should examine the efficacy of genital wart treatment for the prevention of disease.

Section snippets

Materials and methods

Between 1974 and 1993, the Danish Medical Birth Registry recorded 1,206,213 births in Denmark. We identified 3033 women who had genital warts during pregnancy by linking the data in the Danish National Hospital Registry with those in the Danish Medical Birth Registry. A representative sample (n = 7902) of all births was selected by a simple random sample from the Danish Medical Birth Registry database to serve as a comparison group for the women with genital warts. We identified 57 cases of

Results

Of the 1.2 million live births in Denmark during the study period, we identified 57 respiratory papillomatosis cases, corresponding to an overall risk of 4.7 per 100,000 births and an overall rate of 3.5 per 1,000,000 person-years. There were no statistically significant differences (P < .05) of selected characteristics between the 3033 newborns identified from the Danish national registries with a maternal history of genital warts and the 7902 randomly selected sample of births without such a

Discussion

The valuable resource of the Danish national registries allowed for the longitudinal evaluation of maternal and infant characteristics associated with respiratory papillomatosis. Fifty-seven respiratory papillomatosis cases occurring during a follow-up were identified by medical record review, corresponding to an overall rate of 3.5 per 1,000,000 person-years, which is similar to the rate reported by Lindeberg and Elbrond.5 A maternal history of genital warts in pregnancy was identified as the

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    This research was supported in part by a National Cancer Institute grant (RO3 CA86170-01).

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