It is
possible that few of these patients did not
truly have HR-HPV. In addition, it is
possible that women with a normal
Papanicolaou smear may have had either
a false negative cervical cytology test or
acquired HPV later on during the pregnancy.
We attempted to eliminate this
bias by requiring at least 2 normal
Papanicolaou smears, which increase
sensitivity and specificity of the test. HRHPV
is also associated with high risk
sexual behavior, but this history could
not be reliably determined by review of
the obstetric record. This potential
confounder should be included in potential
future studies.