Integrating HPV self-sampling into antenatal care: prevalence, genotype distribution, clinical outcomes, and preventive implications among pregnant women in Thailand

BACKGROUND Cervical cancer remains a major global health burden, particularly in low- and middle-income countries with limited screening coverage. Pregnancy offers an opportunity to integrate preventive interventions into antenatal care (ANC). Human papillomavirus (HPV) self-sampling may improve participation by reducing barriers to conventional screening. OBJECTIVE This study evaluated HPV prevalence, genotype distribution, clinical outcomes, and the feasibility of HPV self-sampling in ANC among pregnant women in Thailand. STUDY DESIGN: This prospective observational study enrolled pregnant women aged ≥ 18 years with a gestational age ≥ 12 weeks attending ANC at Siriraj Hospital, Bangkok, Thailand. Data were collected from July 21, 2025, to January 10, 2026. After standardized instruction, participants performed vaginal HPV self-sampling. HPV was detected and genotyped using multiplex real-time polymerase chain reaction. Outcomes included HPV prevalence, genotype distribution, acceptance, and follow-up among HPV-positive participants. RESULTS Of 644 pregnant women, HPV infection was detected in 147 (overall prevalence, 22.8%). Among HPV-positive participants, HPV16/18 infection was identified in 37 cases (25.2%) and non-16/18 infection in 110 cases (74.8%). HPV52 was the most frequently detected genotype, followed by HPV16, HPV66, HPV51, and HPV68. Younger maternal age, lower income, divorced/separated/widowed status, and smoking-related exposure were independently associated with HPV infection. Notably, 62.4% of participants had never undergone cervical cancer screening. Self-sampling was highly acceptable, mainly for its convenience and ease of use. CONCLUSION HPV self-sampling integrated into ANC was feasible and acceptable among pregnant women. ANC may extend cervical cancer screening to previously underscreened women and support prevention strategies.