Female Human Papillomavirus Infection Associated with Increased Risk of Ectopic Pregnancy: Early Evidence from Taiwan Population-Based Cohort Study

Li-Chuan Hsu; Ting-Yu Tu; Hui-Yuan Chen; Renin Chang; Hei-Tung Yip; Mei-Chia Chou; James Cheng-Chung Wei; Kuan-Hao Tsui; Jim Jinn-Chyuan Sheu

doi:10.3390/jpm12020172

Female Human Papillomavirus Infection Associated with Increased Risk of Ectopic Pregnancy: Early Evidence from Taiwan Population-Based Cohort Study

J Pers Med. 2022 Jan 27;12(2):172. doi: 10.3390/jpm12020172.

Authors

Li-Chuan Hsu^{1

2}, Ting-Yu Tu³, Hui-Yuan Chen⁴, Renin Chang⁵, Hei-Tung Yip^{6

7

8}, Mei-Chia Chou^{9

10

11

12}, James Cheng-Chung Wei^{4

7

13

14}, Kuan-Hao Tsui^{1

2}, Jim Jinn-Chyuan Sheu¹

Affiliations

¹ Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 804201, Taiwan.
² Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan.
³ Department of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan.
⁴ Institute of Medicine, Chung Shan Medical University, Taichung 402306, Taiwan.
⁵ Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan.
⁶ Management Office for Health Data, China Medical University Hospital, Taichung 404332, Taiwan.
⁷ College of Medicine, China Medical University, Taichung 406040, Taiwan.
⁸ Institute of Public Health, National Yangming University, Taipei 112304, Taiwan.
⁹ Department of Recreation and Sports Management, Tajen University, Pingtung 907101, Taiwan.
¹⁰ Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan.
¹¹ Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Pingtung 912012, Taiwan.
¹² Graduate Institute of Bioresources, National Pingtung University of Science and Technology, Pingtung 912301, Taiwan.
¹³ Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung 402306, Taiwan.
¹⁴ Graduate Institute of Integrated Medicine, China Medical University, Taichung 404333, Taiwan.

Abstract

Background: This is an investigation of the human papillomavirus (HPV) infection and its correlation with the risk of ectopic pregnancy (EP).

Methods: The cohort study includes 11,239 patients with newly diagnosed HPV infections between 2000 and 2012, and by using computer-generated random numbers, patients who do not have HPV infections are selected randomly as the comparison cohort. The HPV infection cohort is matched to comparison individuals at a 1:10 ratio by age and index year. All individuals included in the study were followed up to the point they developed EP, pulled-out from the insurance program, lost to follow-up, or until the end of 2013. A Cox proportional-hazards regression analysis was used to analyze the risk of EP with the hazard ratios (HRs) and 95% confidence intervals (CIs) between the HPV and control cohort.

Results: The adjusted hazard ratio (aHR) of EP for HPV patients relative to controls is 1.70 (95% CI = 1.04, 2.78), indicating a positive correlation between EP and HPV in the 13-year follow-up period, after adjusting for age and relevant comorbidities. The sensitivity analyses yield similar results.

Conclusions: A history of HPV infection is a potential risk factor associated with the development of subsequent EP in Taiwanese individuals, especially those diagnosed with an HPV infection within 3 years.

Keywords: cohort study; ectopic pregnancy; human papillomavirus; infection.