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Tristan Manalac, 06 Oct 2017
In women with polycystic ovary syndrome (PCOS), combined oral contraceptive (COC) with spironolactone is more effective than metformin in reducing symptoms while showing a similar safety profile, according to a new randomized clinical trial (RCT).

Quadrivalent HPV vaccine safe during pregnancy, periconceptional period

Tristan Manalac
24 Sep 2017

Quadrivalent vaccines against the human papillomavirus (HPV) are safe and do not cause negative birth or pregnancy outcomes, a recent study has found.

“In this large, multisite observational cohort, inadvertent administration of quadrivalent HPV vaccine during the periconceptional period or during pregnancy was not associated with increased risks of chorioamnionitis, preterm birth, small for gestational age (SGA) birth, or selected major structural birth defects,” said researchers.

“Administration of the quadrivalent HPV vaccine during the periconceptional period or before 20 weeks of gestation was also not associated with hypertensive disorders of pregnancy or gestational diabetes,” they added.

The study included 720 women who received the quadrivalent HPV vaccine during the periconceptual period, 638 who received it during pregnancy and 8,196 who received it during the comparison period (ie, between 4 to 18 months before final menstrual period only).

Chorioamnionitis was reported in 7.5 and 7.3 percent of women who received the HPV vaccine during the periconceptional and comparison periods, respectively, yielding an insignificant adjusted relative risk (aRR) of 1.06 (95 percent CI, 0.80 to 1.4). Adjustments were made for maternal age, year of delivery, poverty and pre-existing conditions. [Obstet Gynecol 2017;130:599-608].

Similarly, there were no significant differences between the periconceptional and comparison groups in terms of the frequencies of hypertensive disorders (7.1 vs 8.2 percent; aRR, 0.86; 0.65 to 1.15), gestational diabetes (5.2 vs 4.9 percent; aRR, 1.02; 0.73 to 1.4), preterm deliveries (7.4 vs 7.6 percent; aRR, 0.92; 0.69 to 1.22) and SGA birth (11.8 vs 11.1 percent; aRR, 1.05; 0.84 to 1.3).

The same trend was observed between the comparison and pregnancy groups. There were no differences in the frequencies of chorioamnionitis (7.2 vs 7.3 percent; aRR 0.95; 0.70 to 1.3), hypertensive disorders (8.7 vs 8.2 percent; aRR, 1.04; 0.79 to 1.4), gestational diabetes (4.7 to 4.9 percent; aRR, 0.98; 0.67 to 1.4), preterm deliveries (7.9 vs 7.6 percent; aRR, 0.97; 0.72 to 1.3) and SGA births (11.7 vs 11.1 percent; aRR, 1.04; 0.82 to 1.3).

The rate of major birth defects in the comparison group was 1.8 percent, which was comparable to that of the periconceptual group (1.8 percent) and pregnancy group (2.0 percent), yielding respective insignificant aRRs of 1.04 (0.75 to 1.5) and 1.0 (0.52 to 1.9).

“In this cohort of insured adolescents and young adults, inadvertent quadrivalent HPV vaccination during the periconceptional period or during pregnancy was not associated with selected adverse maternal or infant outcomes,” summarized researchers.

“This study provides needed data for clinicians and expectant mothers on the relative safety of the quadrivalent HPV vaccine when inadvertently administered in pregnancy,” they said.

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Tristan Manalac, 06 Oct 2017
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