Perinatal Risk Factors Associated With Juvenile Onset Recurrent Respiratory Papillomatosis in Children at Kenyatta National Hospital

Abstract

Background: Juvenile Onset Recurrent Respiratory Papillomatosis is an aggressive disease in children, caused by Human Papilloma virus, which is acquired via vertical transmission, from an infected mother. Development of the disease is dependant on various risk factors. Objective: To describe the perinatal risk factors associated with juvenile onset recurrent respiratory papillomatosis at Kenyatta National Hospital.

Methodology: This was a descriptive cross-sectional study. A total of 45 patients diagnosed with JORRP and their biological mothers were recruited via convenience sampling. Hospital records and ANC books were reviewed. The clinical and neonatal history of the children, and the mother’s perinatal details were taken. Data Analysis: Data was collected using questionnaires, entered into an excel spread sheet, and analyzed using Statistical Software Package version 25. Frequencies and percentages were used to analyze the data, and were displayed in tables. Pearson correlation test was used to test for association between independent risk factors and JORRP. A p value of 0.05 was considered statistically significant. Results: Out of the 45 mothers recruited, majority (51.1%) attained a secondary education. Maternal age at delivery had a median age of 20 years, and had a strong correlation with JORRP (r 0.711; p value 0.001). All mothers delivered in hospital, with majority (97.7%) delivering vaginally, showing an association with JORRP (r 0.806; p value <0.001). Maternal genital warts and delivery complications were associated with JORRP (r 0.0601; p value 0.001) and (r 0.599; p value 0.032) respectively. Procedures done during delivery and history of STD diagnosis or treatment, showed no association with JORRP. The majority of the children (77.7%) were first born, and was associated with JORRP (r 0.602; p value 0.029). There was no gender predilection, APGAR scores were unknown, HIV and neonatal complications had no association with JORRP. Conclusion and Recommendation: Young maternal age, vaginal delivery, genital warts, delivery complications and first borns were risk factors found to be associated with JORRP. No other infant risk factors were found to be associated with JORRP. We recommend educating the public through public health initiatives, on importance of gynecological assessments for women and evaluating the children of at-risk mothers. We also recommend offering feedback to departments like obstetrics and gynecology to customize the management of these mothers, with the goal of preventing complications during the second stage of labor, and to highlight the significance of HPV vaccination for their children, particularly for those with genital warts