The aims of this study were to describe the childbirth preferences of nulliparous women in early pregnancy and to develop a model of the predictors of those preferences. Participants were recruited with Facebook advertisements and data were collected from 344 women via online survey. Predictors were measured using the Utah Test for the Childbearing Year. Predictors of childbirth preferences (type of birth care provider, birth setting, mode of delivery, and use/avoidance of pain medication) were tested using structural equation modeling. Conventional content analysis was employed to analyze women’s reasons for selecting the type of provider and setting they expected for their delivery. Although the majority of respondents preferred physicians and hospital birth, the proportions of women who preferred midwifery care and planned home birth were higher than currently access those types of care in the U.S. More respondents preferred to use pain medication than to avoid it. Over 95% of respondents preferred vaginal delivery. Women who had an internal locus of control and perceived their childbearing role to be one of active participation were more likely than women who saw their role as a passive one to prefer midwifery care, home birth, vaginal delivery, and to avoid pain medication. Women who saw the provider’s role as dominant to their own were more likely to prefer physicians and hospital birth than those who viewed the provider’s role as a collaborative one. The more fearful/painful women expected birth to be, the more likely they were to prefer cesarean delivery.

Bakgrund: En normal graviditet räknas från det att befruktningen skett tills barnet föds, upp till graviditetsvecka 40. Risker för fetala komplikationer ökar när graviditeten fortskrider efter 40 fullgångna graviditetsveckor. Förekomsten av inducerade förlossningar har ökat under de senaste decennierna både i Sverige och resten av världen. Enligt de nya nationella riktlinjerna i Sverige bör kvinnan vara i värkarbete, eller ha fött sitt barn innan graviditetsvecka 42+0. Målet med induktion är att minimera riskerna och sträva efter barnets och moderns hälsofrämjande. Syfte: Syftet var att undersöka hur induktion av förlossning i graviditetsvecka 41 påverkar maternella medicinska förlossningsutfall. Metod: En litteraturöversikt med ett systematiskt tillvägagångssätt genomfördes. Databassökning skedde i databaserna PubMed och CINAHL, vilket genererade 15 kvantitativa artiklar till studiens resultat. Resultat: Studiens huvudfynd sammanfattades med tre huvudkategorier. Den första kategorin var: Induktionens påverkan på akut kejsarsnitt. Den andra kategorin: Induktions påverkan på operativa förlossningar. Den tredje kategorin var: Induktionens påverkan på övriga maternella medicinska komplikationer. Slutsats: Studien fann motstridiga fynd gällande hur induktion under prolongerad graviditet påverkade maternella medicinska förlossningsutfall. Resultaten gällande hur induktion påverkade andelen av akuta kejsarsnitt samt operativa förlossningar var inte entydiga. Påverkan på övriga maternella medicinska komplikationer visade inte någon statistisk signifikant skillnad. / Background: A normal pregnancy is counted from the time fertilization took place until the child is born, up to week 40 of pregnancy. Risks for fetal complications increase as the pregnancy progresses after 40 weeks. The labor inductions have increased in recent decades both in Sweden and the rest of the world. According to the new national guidelines in Sweden, the woman should be in labor, or have given birth to her child before pregnancy week 42+0. The goal of induction is to minimize the risks and strive to promote the health of the child and the mother. Aim: to evaluate how induction of labor at 41 weeks affects maternal medical delivery outcomes. Method: A general literature review with a systematic approach was performed. The data was collected via the databases PubMed and CINAHL. 15 articles with quantitative method were included in the study. Result: The main findings of the study were summarized in three main categories: 1. The impact of induction on emergency caesarean section; 2. The impact of induction on operative deliveries; 3. The impact of the induction on other maternal medical complications. Conclusion: The study found inconsistent findings regarding how induction during prolonged pregnancy affected maternal medical delivery outcomes. The results regarding how induction affected the proportion of emergency cesarean sections and operative deliveries were not clear-cut. The impact on other maternal medical complications did not show any statistically significant difference.

Background: Early Childhood Caries (ECC) is one of the most common chronic illnesses among young children, affecting around 23% of children 2-5 years old, leading to pain, discomfort, and poor quality of life. It is a multi-factorial disease that develops through the combined effects of bacteria, tooth morphology, fermentable carbohydrates, time, and various social factors. Several studies have investigated the associations between dental caries and non-traditional factors acquired during the first years of life including; mode of delivery, breastfeeding, and Environmental Tobacco Smoke (ETS). However, the literature on these associations has been inconsistent. Objective: To investigate the unadjusted and adjusted associations between the presence of Early Childhood Caries (ECC) and Severe-ECC (S-ECC), and three non-traditional factors: breastfeeding, mode of delivery, and ETS, among children 1-5 years old. Methods: A cross-sectional design was employed, and a sample of 112 caregiver/ child dyads was recruited from the ongoing flow of patients at Temple University Maurice H. Kornberg School of Dentistry (TUKSoD). After consent, subjects completed a questionnaire and received a standard intra-oral examination and the American Academy of Pediatric Dentistry (AAPD) Caries-risk Assessment Tool (CAT) by a student doctor. The study was approved by the Temple University Institutional Review Board (Protocol # 23885). Chi-square tests, two-sample t-tests and bivariate logistic regressions were used to assess the unadjusted associations. Two multivariable logistic models were developed for ECC and S-ECC and included demographics, overall CRA, and the three non-traditional risk factors. Results: The prevalence of ECC and S-ECC were 61% and 30%, respectively. The following variables were significant in the unadjusted analysis for both ECC and S-ECC: child’s age, maternal educational attainment, overall AAPD CAT classification, sugary snacks per day, presence of plaque on child’s teeth and ETS. Exposure to ETS was associated with an increased adjusted odds ratio for ECC (aOR=5.39 [95% CI: 1.14-25.33], P=0.033), but not for S-ECC. Furthermore, C-section birth was associated with a decreased adjusted odds ratio for both ECC and S-ECC, respectively (ECC: aOR=0.132 [95% CI: 0.02-0.72], P=0.02; S-ECC: aOR=0.141 [95% CI: 0.026-0.748], P=0.021). With inclusion of the AAPD CAT, demographics, and the three non-traditional factors, the overall model accuracy at predicting ECC was 82.2%. Conclusions and Clinical Relevance: In this study of urban, predominantly African American, and low income children, ECC was found associated with two non-traditional factors, ETS and mode of delivery, suggesting that including them in CRA may improve prediction of future dental caries, and aid in the prevention and treatment of disease. Results from this study support the notion that ECC is a multi-factorial disease, and highlights the importance of adopting oral health education among caregivers. / Clinical Research and Translational Medicine

Objetivo: Avaliar o perfil de citocinas pró-inflamatórias e de melatonina no cordão umbilical e no sangue materno de gestantes hígidas de acordo com a via de parto. Métodos: Entre março e setembro de 2010, foi realizado estudo observacional prospectivo no Hospital Universitário da Universidade de São Paulo. Foram dosadas citocinas (IL-1, IL-6, TNF) e melatonina em pacientes sem doenças clínicas ou complicações obstétricas que entraram em trabalho de parto espontâneo. As concentrações de citocinas e de melatonina foram comparadas de acordo com a via de parto, além do período do dia e do local de coleta. O sangue retirado da veia do cordão umbilical (VCU) era obtido imediatamente após o parto, sendo que após uma hora era colhido o sangue da veia braquial materna (VB). Foram excluídas pacientes com infecção, parto prematuro e sofrimento fetal. Resultados: Foram estudadas 50 parturientes, das quais 25 evoluíram para parto vaginal e 25 para cesárea. A idade materna foi em média 26,0 ± 6,7 anos. A idade gestacional no parto foi em média 39,5 ± 1,7 semanas. O peso médio dos recém-nascidos foi 3366,5 ± 340,2 gramas. Todos os casos receberam analgesia durante o parto (analgesia combinada: peridural e raquianestesia). A maioria das pacientes era de nulíparas (31/50 - 62,0%). A duração do trabalho de parto foi semelhante nas pacientes que evoluíram para o parto vaginal (7,6 ± 4,4 horas) e nas que foram submetidas à operação cesariana (8,2 ± 4,4 horas; p=0,87). Houve tendência de níveis mais elevados de melatonina no VCU e na VB em pacientes após parto vaginal, porém sem diferença estatística (p=0,41 e p=0,16). Pacientes que evoluíram para cesariana apresentaram dosagens significativamente maiores de TNF na VB, de IL-1 na VCU e na VB e de IL-6 na VCU que em pacientes que evoluíram para parto vaginal (p= 0,02; p<0,01; p<0,01 e p<0,01; respectivamente). Observou-se variação no ritmo circadiano das dosagens dessas citocinas após cesariana, com correlação significativa entre dosagem de melatonina e de citocinas nessa via de parto. Conclusão: Pacientes submetidas à operação cesariana apresentaram tendência a redução da secreção de melatonina, com aumento significativo da secreção de citocinas pró-inflamatórias, o que pode ser conseqüência do processo inflamatório relacionado ao estresse cirúrgico / Objetive: To evaluate the profile of pro-inflammatory cytokines and the melatonin level in maternal and umbilical cord blood samples in accordance with the mode of delivery. Methods: Between March 2010 and September 2010, a prospective observational study was conducted at University Hospital of University of São Paulo. Cytokines (IL-1, IL-6, TNF) and melatonin levels were analyzed from maternal brachial vein (BV) and umbilical cord vein (UCV) obtained from healthy patients that started spontaneous labor. The levels of cytokines and melatonin were evaluated in accordance to the mode of delivery as well as the day period and the local of blood sample (UCV - immediately after delivery and BV - one hour after delivery). Patients with infection, preterm labor and fetal distress were excluded. Results: A total of 50 patients were evaluated in the present study: 25 underwent vaginal delivery and 25 c-section. Mean maternal age was 26.0 ± 6.7 years. Mean gestational age at delivery was 39.5 ± 1.7 weeks. The average of newborn weight was 3366.5 ± 340.2 grams. All patients had combined epidural and raquianesthesia. The majority of the patients was nullipara (31/50 62.0%). The labor duration was similar in patients that underwent vaginal delivery (7.6 ± 4.4 hours) or c-section (8.2 ± 4.4 hours, p=0.87). There was a tendency of increased levels of melatonin in the UCV and BV samples after vaginal deliveries, but with statistical significance (p=0.41 and p=0.16). Patients that underwent c-section had increased levels of TNF at the BV, IL-1 at the UCV and BV and IL-6 at the UCV than in patients that underwent vaginal delivery (p= 0.02; p<0.01; p<0.01 and p<0.01; respectively). Circadian variations of the cytokines and the melatonin levels were observed in patients that underwent c-section, with significant correlation between the levels of cytokines and melatonin. Conclusion: Patients that underwent c-section had a tendency of reduced melatonin level, with significant increase in the cytokine levels, which may be consequent of the inflammatory process related to the surgical stress.

Objetivo: Avaliar o perfil de citocinas pró-inflamatórias e de melatonina no cordão umbilical e no sangue materno de gestantes hígidas de acordo com a via de parto. Métodos: Entre março e setembro de 2010, foi realizado estudo observacional prospectivo no Hospital Universitário da Universidade de São Paulo. Foram dosadas citocinas (IL-1, IL-6, TNF) e melatonina em pacientes sem doenças clínicas ou complicações obstétricas que entraram em trabalho de parto espontâneo. As concentrações de citocinas e de melatonina foram comparadas de acordo com a via de parto, além do período do dia e do local de coleta. O sangue retirado da veia do cordão umbilical (VCU) era obtido imediatamente após o parto, sendo que após uma hora era colhido o sangue da veia braquial materna (VB). Foram excluídas pacientes com infecção, parto prematuro e sofrimento fetal. Resultados: Foram estudadas 50 parturientes, das quais 25 evoluíram para parto vaginal e 25 para cesárea. A idade materna foi em média 26,0 ± 6,7 anos. A idade gestacional no parto foi em média 39,5 ± 1,7 semanas. O peso médio dos recém-nascidos foi 3366,5 ± 340,2 gramas. Todos os casos receberam analgesia durante o parto (analgesia combinada: peridural e raquianestesia). A maioria das pacientes era de nulíparas (31/50 - 62,0%). A duração do trabalho de parto foi semelhante nas pacientes que evoluíram para o parto vaginal (7,6 ± 4,4 horas) e nas que foram submetidas à operação cesariana (8,2 ± 4,4 horas; p=0,87). Houve tendência de níveis mais elevados de melatonina no VCU e na VB em pacientes após parto vaginal, porém sem diferença estatística (p=0,41 e p=0,16). Pacientes que evoluíram para cesariana apresentaram dosagens significativamente maiores de TNF na VB, de IL-1 na VCU e na VB e de IL-6 na VCU que em pacientes que evoluíram para parto vaginal (p= 0,02; p<0,01; p<0,01 e p<0,01; respectivamente). Observou-se variação no ritmo circadiano das dosagens dessas citocinas após cesariana, com correlação significativa entre dosagem de melatonina e de citocinas nessa via de parto. Conclusão: Pacientes submetidas à operação cesariana apresentaram tendência a redução da secreção de melatonina, com aumento significativo da secreção de citocinas pró-inflamatórias, o que pode ser conseqüência do processo inflamatório relacionado ao estresse cirúrgico / Objetive: To evaluate the profile of pro-inflammatory cytokines and the melatonin level in maternal and umbilical cord blood samples in accordance with the mode of delivery. Methods: Between March 2010 and September 2010, a prospective observational study was conducted at University Hospital of University of São Paulo. Cytokines (IL-1, IL-6, TNF) and melatonin levels were analyzed from maternal brachial vein (BV) and umbilical cord vein (UCV) obtained from healthy patients that started spontaneous labor. The levels of cytokines and melatonin were evaluated in accordance to the mode of delivery as well as the day period and the local of blood sample (UCV - immediately after delivery and BV - one hour after delivery). Patients with infection, preterm labor and fetal distress were excluded. Results: A total of 50 patients were evaluated in the present study: 25 underwent vaginal delivery and 25 c-section. Mean maternal age was 26.0 ± 6.7 years. Mean gestational age at delivery was 39.5 ± 1.7 weeks. The average of newborn weight was 3366.5 ± 340.2 grams. All patients had combined epidural and raquianesthesia. The majority of the patients was nullipara (31/50 62.0%). The labor duration was similar in patients that underwent vaginal delivery (7.6 ± 4.4 hours) or c-section (8.2 ± 4.4 hours, p=0.87). There was a tendency of increased levels of melatonin in the UCV and BV samples after vaginal deliveries, but with statistical significance (p=0.41 and p=0.16). Patients that underwent c-section had increased levels of TNF at the BV, IL-1 at the UCV and BV and IL-6 at the UCV than in patients that underwent vaginal delivery (p= 0.02; p<0.01; p<0.01 and p<0.01; respectively). Circadian variations of the cytokines and the melatonin levels were observed in patients that underwent c-section, with significant correlation between the levels of cytokines and melatonin. Conclusion: Patients that underwent c-section had a tendency of reduced melatonin level, with significant increase in the cytokine levels, which may be consequent of the inflammatory process related to the surgical stress.

This doctoral thesis provides a set of studies of social influences on fertility timing. Swedish register data are used to link individuals to their parents and siblings, thereby allowing the study of impacts of family of origin, social background, and parental death on fertility. The Swedish Medical Birth Register is used to investigate the effect of mode of delivery on higher order births. The thesis consists of an introductory chapter with an overview of the consequences and predictors of the timing of childbearing, and a theoretical framework to explain these relationships. This chapter also includes a section where the contribution to existing knowledge, the relation of the findings to life course theory, and suggestion for further research are discussed. This chapter is followed by four original empirical studies. The first study applies sister and brother correlations to investigate and estimate the impact of family of origin on fertility. It shows that family of origin matters for fertility timing and final family size. The study also shows that the overall importance of family of origin has not changed over the approximately twenty birth cohorts that were studied. The second study introduces three dimensions of social background - occupational class, status, and education - into fertility research. It suggests that social background, independent of individuals’ own characteristics, matters for the timing of first birth and the risk of childlessness. The study also shows that different dimensions of social background should not be used interchangeably. The third study uses the Swedish Medical Birth Register to investigate the effect of mode of delivery on the propensity and birth interval of subsequent childbearing. It demonstrates that mode of delivery has an impact on the progression to the second and third births but that a first delivery by vacuum extraction does not reduce the propensity of subsequent childbearing to the same extent as a first delivery by emergency or elective caesarean section. The fourth study explores the effects of parental death on adult children's fertility. The findings reveal that parental death during reproductive ages can affect children’s fertility. The effects are moderated by the gender of the child and when in the life course bereavement occurs. The combined output of these four studies provides evidence that human fertility behavior is embedded in social relationships with kin and friends throughout life. Family of origin, social background, an older sibling's birth, and bereavement following parental death influence the adult child's fertility. These findings add knowledge to previous research on intergenerational and social network influences in fertility.

Professional development of teachers is a much-investigated area of research; however, teachers still complain that these endeavours do not cater for their specific needs. This problem arises from teachers‟ need to have more frequent professional development activities whereby it is possible to enhance their knowledge and skills regarding specific areas effectively. Multimedia, in other words the use of various media such as video, pictures, narration and animation, is a possible tool to address certain needs in professional development. Furthermore, the incorporation of multimedia into professional development by making use of a digital versatile disc allows for professional development to occur within a distance mode of delivery setting. This research was done to investigate and understand how Information Technology teachers experience the incorporation of multimedia into professional development by means of digital versatile disc. In order to accomplish this research endeavour, an investigation into the body of scholarly knowledge was executed focused on professional development of teachers, specifically with regard to needs expressed in previous studies. Furthermore, the body of scholarly knowledge regarding the implementation of multimedia as an enhancement to professional development was also investigated in order to synthesise how the researcher should go about implementing it. From the knowledge gained, the researcher developed the professional development digital versatile disc, specifically focused on the programming language Scratch. This programming language is an addition to the Information Technology syllabus and therefore teachers were assisted in their endeavour to acquire knowledge and skills regarding the implementation of such a new programming language. An empirical study was conducted, specifically focusing on the experience of three teachers to determine how they experience multimedia-based professional development. All three participants expressed that they enjoyed the use of multimedia in professional development and that a digital versatile disc of this type had a place in their professional development endeavours; however, a need for personal interaction with the facilitator as well as colleagues still exists. / Thesis (MEd (Computer Science Education))--North-West University, Potchefstroom Campus, 2013

Professional development of teachers is a much-investigated area of research; however, teachers still complain that these endeavours do not cater for their specific needs. This problem arises from teachers‟ need to have more frequent professional development activities whereby it is possible to enhance their knowledge and skills regarding specific areas effectively. Multimedia, in other words the use of various media such as video, pictures, narration and animation, is a possible tool to address certain needs in professional development. Furthermore, the incorporation of multimedia into professional development by making use of a digital versatile disc allows for professional development to occur within a distance mode of delivery setting. This research was done to investigate and understand how Information Technology teachers experience the incorporation of multimedia into professional development by means of digital versatile disc. In order to accomplish this research endeavour, an investigation into the body of scholarly knowledge was executed focused on professional development of teachers, specifically with regard to needs expressed in previous studies. Furthermore, the body of scholarly knowledge regarding the implementation of multimedia as an enhancement to professional development was also investigated in order to synthesise how the researcher should go about implementing it. From the knowledge gained, the researcher developed the professional development digital versatile disc, specifically focused on the programming language Scratch. This programming language is an addition to the Information Technology syllabus and therefore teachers were assisted in their endeavour to acquire knowledge and skills regarding the implementation of such a new programming language. An empirical study was conducted, specifically focusing on the experience of three teachers to determine how they experience multimedia-based professional development. All three participants expressed that they enjoyed the use of multimedia in professional development and that a digital versatile disc of this type had a place in their professional development endeavours; however, a need for personal interaction with the facilitator as well as colleagues still exists. / Thesis (MEd (Computer Science Education))--North-West University, Potchefstroom Campus, 2013

Background: In Sweden, annually, approximately 1,5% out of 115 000 newborns are twins. Itis widely documented that multiple gestation pregnancy contributes to an increased risk of maternal morbidity. Nevertheless, the direct impact of multiple gestation on some maternal complications remains debated. The expected difference in maternal characteristics between populations may also contribute to divergent conclusions. Objective: The aim of this study is to assess the risk of maternal complications and the occurrence of different mode of delivery during pregnancy and childbirth in nulliparous women with multiple gestation. Study design: A population-based cohort study based on data from the Swedish Medical Birth Register between 1999 and 2017.Results: In total 13 014 nulliparous women with multiple gestation and 850 021 nulliparous women with single gestation were included in the study. Women with multiple gestation were slightly older and more often gave birth prematurely than single gestation counterparts. Pregnancy through IVF were almost five times as common in the multiple gestation group. These women suffered a four times increased risk of both preeclampsia and severe forms of preeclampsia. Multiple gestation in nulliparous women was, in this cohort, associated with nearly six times elevated risk of developing ICP, relative to single gestation counterparts. Intrapartal bleeding and post-partum hemorrhage were also more common in women with multiple gestation. The majority of the nulliparous women with multiple gestation had a caesarean section, elective or acute, while nulliparous women with single gestation more often delivered vaginally. An increased risk for placenta previa and GDM, as a consequence of multiple gestation, could, however, not be observed in this study. Conclusion: Multiple gestation is associated with increased risk of several obstetric complications. It is important that healthcare professionals become fully aware of these risks in the encounter with the woman in order to be able convey appropriate information and take appropriate preventive measures. Continued work to reduce multiple gestation caused by IVF is also recommended. / Bakgrund: I Sverige föds ca 115 000 barn årligen och av dessa är knappt 1,5% tvillingar. Flerbördsgraviditet innebär ökad risk för maternell morbiditet, men forskningen går isär gällande flerbörds inverkan på somliga komplikationer. Dessutom kan variationer i maternella karakteristika skilja sig åt mellan populationer. Syfte: Syftet med denna uppsats är att studera risken för maternella komplikationer samt förekomst av olika förlossningssätt under graviditet och förlossning vid flerbörd hos förstföderskor. Metod: En populationsbaserad kohortstudie utifrån data från Medicinska födelseregistret mellan åren 1999–2017.Resultat: Totalt ingick 13 014 förstföderskor gravida med flerbörd i studien och 850 021enkelbörd. Flerbördsgruppen var något äldre än de i enkelbördsgruppen och de födde oftare prematurt. Graviditet genom IVF var nästan fem gånger så vanligt i flerbördsgruppen. Preeklampsi och svår preeklampsi var fyra gånger så stor i flerbördsgruppen och risken för ICP var nästan sex gånger så stor. Även intrapartal blödning och PPH var betydligt vanligare hos kvinnorna i flerbördsgruppen. Majoriteten av personerna i flerbördsgruppen förlöstes medkejsarsnitt, planerat eller akut, medan förstföderskorna i enkelbördsgruppen i större utsträckning födde vaginalt. Ökad risk för placenta praevia och GDM kunde ej observeras. Slutsats: Att vänta flerbörd är förenat med en ökad risk för flera obstetriska komplikationer. Denna risk är viktigt att vårdpersonal är medvetna om i mötet med kvinnan för att kunna informera, förebygga och behandla. Även ett fortsatt arbete att minska flerbörd som uppkommit genom IVF rekommenderas.

Contexte : La littérature suggère que le virus du papillome humain (VPH) puisse être transmis verticalement. Or, le mécanisme exact de transmission verticale demeure inconnu et les données ne permettent pas de savoir dans quelle mesure la transmission verticale est affectée par le mode d’accouchement. L’objectif de l’étude était de mesurer l’association entre le mode d’accouchement et la détection d’ADN du VPH chez les bébés. Méthode : Nous avons utilisé les données de 1052 femmes enceintes de la cohorte HERITAGE. Des échantillons vaginaux auto-collectés ont été obtenus chez les mères durant la grossesse, et des échantillons des muqueuses de la bouche, la gorge, les yeux et de la région anogénitale ont été collectés chez les bébés à la naissance et à 3 mois. Nous avons inclus les 282 femmes ayant eu un test VPH positif au premier et troisième trimestre de grossesse. Tous les échantillons ont été analysés pour la détection d’ADN du VPH par la méthode de réaction de polymérase en chaîne (PCR) avec le test Linear ArrayMC. Les informations sur l’accouchement ont été collectées dans les dossiers médicaux. L’association entre le mode d’accouchement et la transmission verticale du VPH a été mesurée par régressions logistiques. Résultats : La probabilité de transmission verticale du VPH a été de 8,9% (25/282), soit 3,7% (3/81) pour les césariennes et 10,9% (22/201) pour les accouchements vaginaux. Chez 21 des 25 enfants positifs au VPH (84%), il y avait au moins un génotype concordant avec leur mère, et tous sont nés par accouchement vaginal. Une augmentation significative du risque de transmission verticale du VPH a été observée pour l’accouchement vaginal, en comparaison avec la césarienne (OR ajusté: 3,63, intervalles de confiance à 95% (IC 95%): 1,03-12,82). Nous n’avons pas observé d’association significative entre la césarienne suivant la rupture des membranes et le risque de transmission, lorsque comparé avec la césarienne avec membranes intactes (OR ajusté : 1,31, IC 95% : 0,10-17,76). Il n’y a pas eu d’association entre la durée écoulée entre la rupture des membranes et la naissance (en heures continues) et le risque de transmission verticale (OR : 1,00, IC 95% : 0,97-1,02). Conclusion : L’accouchement par césarienne a été associé à un risque significativement plus faible de transmission du VPH chez les bébés. La transmission verticale du VPH surviendrait principalement lors du passage dans le canal vaginal car très peu d’enfants nés par césarienne ont été infectés au VPH. Puisque la rupture des membranes avant la césarienne et la durée entre la rupture des membranes et la naissance n’ont pas été associées à un risque de transmission du VPH plus élevé, nos résultats suggèrent que la transmission par infection ascendante après rupture des membranes est probablement rare. / Background: The literature suggests that human papillomavirus (HPV) can be transmitted vertically. However, the exact mechanism of vertical transmission remains unknown and the data do not allow us to know to what extent vertical transmission is affected by the mode of delivery. The aim of the study was to measure the association between mode of delivery and the detection of HPV DNA in infants. Method: We used data from 1052 pregnant women from the HERITAGE cohort. Self-collected vaginal samples were obtained from mothers during pregnancy, and specimens from the mucous membranes of the mouth, throat, eyes and anogenital region were collected from infants at birth and at 3 months. We included 282 women who had both positive HPV tests in the first and third trimester of pregnancy. All samples were analyzed for detection of HPV DNA by the polymerase chain reaction (PCR) method with the Linear ArrayTM assay. Information about the delivery was collected from medical records. The association between the mode of delivery and HPV detection in infants was measured using logistic regressions. Results: The probability of transmission of HPV was 8.9% (25/282); 3.7% (3/81) for caesarean sections and 10.9% (22/201) for vaginal deliveries. In 21 of 25 HPV positive infants (84%), there was at least one genotype concordant with their mother, and all were born vaginally. A significant increase in the risk of transmission of HPV was observed for vaginal delivery, compared to caesarean section (adjusted OR: 3.63, 95% confidence intervals (95% CI): 1.03-12.82). We found no significant increase in the risk of HPV transmission for caesarean section following rupture of membranes, compared to caesarean section with intact membranes (adjusted OR: 1.31, 95% CI: 0.10-17.76). There was no association between the time between rupture of membranes and birth (in continuous hours) and the risk of vertical transmission (OR: 1.00, 95% CI: 0.97-1.02). Conclusion: Caesarean delivery is associated with a significantly lower risk of HPV vertical transmission. Vertical transmission is thought to occur mainly during passage through the vaginal canal, because very few infants born by caesarean section have been infected with HPV. Since rupture of membranes before caesarean section and the time between ruptured membranes and birth have not been associated with a higher risk of HPV transmission, our results suggest that transmission by ascending infection after rupture of membranes is unlikely.