妊娠期人乳头瘤病毒感染对母儿影响的探讨  

Influence of Human Papillomavirus Infection during Pregnancy on Mothers and Children

作　　者：郑晓霞[1] 王谢桐[2] 于珊[1] 

机构地区：[1]山东省济南市妇幼保健院,山东济南250001 [2]山东省立医院,山东济南250021

出　　处：《实用妇产科杂志》2011年第3期223-226,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨妇女妊娠期下生殖道人乳头瘤病毒(HPV)感染垂直传播及对婴儿的近期影响和母乳喂养与其传播的关系。方法:选择HPV感染的孕妇203例(研究组)和HPV阴性的正常孕妇(对照组)344例为研究对象,在分娩时取两组孕妇羊水、胎儿脐静脉血行HPV检测,做胎盘病理检查,并分析其母婴结局;同时对研究组新生儿的咽喉分泌物或外阴分泌物及产妇乳汁HPV进行检测,并随访产后半年和1年产妇乳汁HPV检测,及进行产后6月、12月、24月婴儿咽喉分泌物、外阴分泌物HPV检测。结果:①203例HPV阳性孕妇中,17例孕早、中期终止妊娠,余186例继续妊娠:阴道分娩89例(47.8%),剖宫产分娩97例(52.2%)。研究组胎膜早破、早产、胎儿生长受限、新生儿呼吸窘迫综合征、产后出血、产褥感染发生率与对照组相比,差异无统计学意义(P>0.05);②研究组分娩新生儿共186例,新生儿HPV感染128例,阳性率为68.8%。其中阴道分娩57例,剖宫产71例,两组比较差异无统计学意义(P>0.05);③研究组婴儿HPV转归:产后6个月婴儿HPV阳性率32.8%,产后12个月阳性率3.8%。产后两年复查,均转为阴性;④乳汁HPV检测:初乳HPV阳性率29.6%,产后6个月复查阳性率为5.4%。结论:HPV可经垂直传播途径引起宫内感染,剖宫产不能阻止新生儿HPV感染。但婴幼儿的转阴率极高,未见胎儿、婴儿生长发育异常及新生儿呼吸道乳头瘤。母乳喂养不增加婴儿HPV感染几率。HPV感染不是人工终止妊娠的指征。Objective：To study the vertical spread of HPV in pregnancy and its short term effect on infants,to clarify the relationship of breast milk feeding and HPV spread.Methods：203 HPV positive pregnant women（study group） and 344 HPV negative pregnant women（control group） were recruited in this study.The amniotic fluid and umbilical cord vein blood at delivary were collected for HPV test,also the placentas were sent for pathologic examination.Pharynx and vulva or pennis secretion of the newborns and 6,12,24 month after delivary in study group were tested for HPV infection.Breast milk of the study group was collected after delivary and 6,12 month postpartum for HPV test.Results：①For the study group,17 pregnancy were terminated during the first and second trimester,89 women had spontaneous vaginal delivary（47.8%）,97 women had cesarean section（52.2%）.The percentages of premature rupture of membrane,premature delivery,fetal growth restriction,fetal distress and peupery infection in vaginal delivary group were no difference compared with those in cesarean group（P〈0.05）.②186 babies were born in the study group,128 babies（68.8%） had HPV positive result,57 babies were vaginal delivary,71 babies were cesarean section,there was no significant difference between the two delivary modes.③HPV positive rates of babies 6 and 12 month after delivary were 32.8% and 3.8% respectively,also two years later,all the babies were negative.④HPV positive rates of breast milk were 29.6% and 5.4% at delivary and 6 month postpartum.Conclusions：HPV can be verically transmitted,cesarean section can not prevent newborns＇ infection,however,most HPV positive results can be reverted in babies,no abnormity of fetus and babies and respiratory tract papilloma in newborns were found.Breast feeding does not increase the infection rate of babies.HPV infection is not an indication of cesarean section.

关 键 词：人乳头瘤病毒 妊娠 垂直传播 母乳喂养 

分 类 号：R714.25[医药卫生—妇产科学] R373[医药卫生—临床医学]