**7. Conclusion**

In pregnant women, many observational studies reported the HPV infection risk but there are controversial results too. Higher HPV prevalence has been reported in few studies, whereas several studies reported lower prevalence in pregnant women or there is no statistical difference between pregnant and age matched non-pregnant controls [16].

For a successful pregnancy, a modulated, dynamic and responsive immune system is required but definitely not a suppressive one and this has been supported by an increasing number of studies. At the feto-maternal interface, the trophoblastic cells are important for the receptive immune system establishment which is achieved as a part of response mechanism to the normal microbiota which highlights the complexity of the regulatory pathways involved during pregnancy. Moreover, there are evidences on the effects that changed the modulated immune system and the receptive feto-maternal interface by a clinically silent viral infection emphasizes the necessity of better detection, treatment and prevention of the viral infections during pregnancy. This will further lead not only to the better outcomes

**79**

*Human Papillomavirus Infections in Pregnant Women and Its Impact on Pregnancy Outcomes…*

of pregnancy but also the postnatal development can be affected in a better way as these viral infections and the subsequent inflammations reported to be associated with mental health issues and diseases of the immune system such as asthma and allergies. The effects of viral infections on fetal development during pregnancy can more be exemplified by the recent Zika virus outbreak and its teratogenic effect on the development of brain [22]. Therefore, it is important to understand the complex immune responses during pregnancy, with the continued risk of pandemics and the emergence of newer diseases associated as secondary to the viral infection, which will lead to the development of appropriate approaches and tools to protect both the

Moreover, there are very limited data is available due to the very limited number of investigations have been performed on materials from spontaneous abortions and spontaneous preterm deliveries due to HPV infection and the heterogeneous study groups making it difficult to come to a reliable conclusion. A proper study design, selection of proper controls is very essential in this case and a strict control of the similarity in patients/samples is needed for a valuable comparison between studies. Furthermore, the simple detection of a virus cannot be a real causative role for diseases in general or adverse pregnancy outcomes. Therefore, for this particular situation it is important to study the cellular localization and the viral activity to

Therefore, we recommend more investigations on materials of adverse pregnancy outcomes including spontaneous abortion and spontaneous preterm delivery and the molecular mechanism of HPV infections on it which is the need of the hour and researchers need to conduct new studies to clarify the exact molecular mechanisms involved on the HPV infection in early pregnancy and how the self-clearance

Sanchita Roy Pradhan, Sutapa Mahata, Dipanwita Ghosh, Pranab Kumar Sahoo,

Department of Pathology and Cancer Screening, Chittaranjan National Cancer

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

*DOI: http://dx.doi.org/10.5772/intechopen.90197*

fetus and the mother [41].

come to a realistic conclusion.

**Conflict of interest**

**Author details**

Institute, Kolkata, India

takes place during the course of pregnancy.

The authors declare no conflict of interest.

Sinjini Sarkar, Ranita Pal and Vilas D. Nasare\*

provided the original work is properly cited.

\*Address all correspondence to: vilas.dr@gmail.com

### *Human Papillomavirus Infections in Pregnant Women and Its Impact on Pregnancy Outcomes… DOI: http://dx.doi.org/10.5772/intechopen.90197*

of pregnancy but also the postnatal development can be affected in a better way as these viral infections and the subsequent inflammations reported to be associated with mental health issues and diseases of the immune system such as asthma and allergies. The effects of viral infections on fetal development during pregnancy can more be exemplified by the recent Zika virus outbreak and its teratogenic effect on the development of brain [22]. Therefore, it is important to understand the complex immune responses during pregnancy, with the continued risk of pandemics and the emergence of newer diseases associated as secondary to the viral infection, which will lead to the development of appropriate approaches and tools to protect both the fetus and the mother [41].

Moreover, there are very limited data is available due to the very limited number of investigations have been performed on materials from spontaneous abortions and spontaneous preterm deliveries due to HPV infection and the heterogeneous study groups making it difficult to come to a reliable conclusion. A proper study design, selection of proper controls is very essential in this case and a strict control of the similarity in patients/samples is needed for a valuable comparison between studies. Furthermore, the simple detection of a virus cannot be a real causative role for diseases in general or adverse pregnancy outcomes. Therefore, for this particular situation it is important to study the cellular localization and the viral activity to come to a realistic conclusion.

Therefore, we recommend more investigations on materials of adverse pregnancy outcomes including spontaneous abortion and spontaneous preterm delivery and the molecular mechanism of HPV infections on it which is the need of the hour and researchers need to conduct new studies to clarify the exact molecular mechanisms involved on the HPV infection in early pregnancy and how the self-clearance takes place during the course of pregnancy.
