Abstract:Objective To investigate the infection rate of human papillomavirus(HPV)among pregnant women,and to explore the effect of HPV infection on adverse pregnancy outcome. Methods A total of 1 679 pregnant women in hospital were collected for the research. The flow-through hybridization and genechip(HybriMax) method was used to detect the infection of HPV. Univariate analysis was used to analyze the factors affecting HPV infection in pregnant women. The binary logistic analysis was used to analyze risk factors affecting adverse pregnancy outcome. Results HPV infection rate was 31.39%(527/1 679),including 14.23%(239/1 679)of HR-HPV,15.54%(261/1 679)of LR-HPV and 1.61%(27/1 679)of mixed of HR-HPV and LR-HPV. Univariate analysis showed that there was significant difference in initial sex age,education level and smoking history between infection group and non-infection group,with statistical difference(P<0.05). The incidence rate of adverse pregnancy outcomes in infection group(31.50%) was significant higher than that of non-infection group(9.81%),with statistical difference(P<0.01). The incidence rate of premature rupture of fetal membranes,newborn respiratory papillomatosis and other adverse pregnancy outcomes among HR-HPV group,LR-HPV group and mixed group had no significant difference(P>0.05). Binary logistic regression analysis showed HR-HPV infection(OR=4.194,95%CI:3.099-5.675),LR-HPV infection(OR=1.771,95%CI:1.288-2.434)and mixed type infection(OR= 3.350,95%CI:1.630-7.735)were the risk factors affecting adverse pregnancy outcome(P<0.01),however,age and times of gestation had no statistical significance in the binary logistic analysis(P>0.05). Conclusion HPV infection was the risk factors for adverse pregnancy outcome,which indicated that screening work in pre-pregnancy and pregnancy,and persisting in early prevention,early detection and early treatment could reduce the incidence rate of adverse pregnancy outcome.
[1] HAN L,MAIMAITIMING T,HUSAIYIN S,et al. Comparative study of HPV16 integration in cervical lesions between ethnicities with high and low rates of infection with high-risk HPV and the correlation between integration rate and cervical neoplasia[J]. Exp Ther Med,2015,10(6):2169-2174. [2] ALVAREZ R D,HUH W K,BAE S,et al. A pilot study of pNGVL4a-CRT/E7(detox)for the treatment of patients with HPV16+cervical intraepithelial neoplasia 2/3 (CIN2/3) [J]. Gynecol Oncol,2015,140(2):245-252. [3] 何友梅,吴小芬,陶国芝. 宫颈上皮内瘤变患病危险因素分析[J]. 预防医学,2017,29(5):524-526. [4] VERMA G,VISHNOI K,TYAGI A,et al. Characterization of key transcription factors as molecular signatures of HPV-positive and HPV-negative oral cancers[J]. Cancer Med,2017,6(3):591-604. [5] NIYIBIZI J,ZANRE N,MAYRAND M,et al. The association between adverse pregnancy outcomes and maternal human papillomavirus infection:a systematic review protocol[J]. Syst Rev,2017,6(1):53-64. [6] 廖琪. 妊娠期孕妇HPV病毒感染的分型及母婴妊娠结局的影响[J]. 中国性科学,2017,26(6):127-128. [7] SSHELLER N M,PASTERNAK B,MØLGAARD-NIELSEN D,et al. Quadrivalent HPV vaccination and the risk of adverse pregnancy outcomes[J]. N Engl J Med,2017,376(13):1223-1233. [8] NIYIBIZI J,ZANRE N,MAYRAND M H,et al. The association between adverse pregnancy outcomes and maternal human papillomavirus infection:a systematic review protocol[J]. Syst Rev,2017,6(1):53-63. [9] 邓雅静,杜琳. 妊娠晚期HPV潜伏感染对妊娠的影响分析[J]. 中国性科学,2013,22(5):62-64. [10] 王晋萍,李占辉. 孕期HPV感染对宫颈病变的发生率及感染的相关影响因素研究[J]. 中国实验诊断学,2016,20(7):1111-1112. [11] SNYMAN L C,DREYER G,VISSER C,et al. The vaccine and cervical cancer screen project 2 (VACCS 2):Linking cervical cancer screening to a two-dose HPV vaccination schedule in the South-West District of Tshwane,Gauteng,South Africa[J]. S Afr Med J,2015,105(3):191-194. [12] 姚成莲,程刚,胡秀美,等. 外来务工女性人乳头瘤病毒感染状况及其认知度调查[J]. 浙江预防医学,2012,24(12):64-66. [13] 张丽华,常晓红,范亚丽,等. 2012—2015年妇科患者感染人乳头瘤病毒型别及相关因素分析[J]. 中国病原生物学杂志,2017,12(1):83-86. [14] SKINNER S R,SZAREWSKI A,ROMANOWSKI B,et al. Efficacy,safety,and immunogenicity of the human papillomavirus 16/18 AS04-adjuvanted vaccine in women older than 25 years:4-year interim follow-up of the phase 3,double-blind,randomised controlled VIVIANE study[J]. Lancet,2014,384(9961):2213-2227. [15] MERCKX M,LIESBETH W V,ARBYN M,et al. Transmission of carcinogenic human papillomavirus tyes from mother to child:a meta-analysis of published studies[J]. Eur J Cancer Prev,2013,22(3):277-285. [16] 尹香花,石敏. 妊娠期人乳头状瘤病毒感染母婴传播及预后的研究进展[J]. 中国妇产科临床杂志,2015,16(3):286-288. [17] CHO G J,MIN K J,HONG H R,et al. High-risk human papillomavirus infection is associated with premature rupture of membranes[J]. BMC Pregnancy Childbirth,2013,13(1):1-4. [18] 秦博文,应佳,雷倩,等. 陕西省妇女既往生育史与末次妊娠早产的相关分析[J]. 中华流行病学杂志,2017,38(2):158- 162.