HPV感染与不良妊娠结局的关系研究  

Association between human papillomavirus infection and adverse pregnancy outcome

作　　者：周静[1] 欧荣英[1] 周美茜[1] 陈香娟[1] 包影[1] 张文淼[1] ZHOU Jing;OU Rong-ying;ZHOU Mei-qian;CHEN Xiang-juan;BAO Ying;ZHANG Wen-miao(Department of Obstetrics,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州医科大学附属第一医院产科,浙江温州325000

出　　处：《预防医学》2018年第1期12-15,共4页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：国家自然科学基金(81373075)

摘　　要：目的了解妊娠期女性人乳头瘤病毒(HPV)感染现状及其对妊娠结局的影响,为预防不良妊娠结局提供参考。方法纳入2015—2017年4月在温州医科大学附属第一医院产科门诊建卡的1 679名孕妇,收集年龄、孕产次和妊娠结局等资料,采集宫颈细胞并应用导流杂交基因芯片技术检测HPV,分析HPV感染的影响因素及其对妊娠结局的影响。结果调查孕产妇1 679人,其中HPV阳性527例,感染率为31.39%;感染组与未感染组首次性行为年龄、文化程度及吸烟史比较,差异均有统计学意义(P<0.05)。HPV感染组不良妊娠结局发生率为31.50%,高于未感染组的9.81%(P<0.05);高危型、低危型和混合型HPV感染组胎膜早破、新生儿呼吸道乳头瘤和其他不良妊娠结局发生率差异均无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,感染HPV是发生不良妊娠结局的危险因素(OR高危型=4.194,95%CI:3.099~5.675;OR混合型=3.350,95%CI:1.630~7.735;OR低危型=1.771,95%CI:1.288~2.434),年龄、孕产次与是否发生不良妊娠结局均未见统计学关联(P>0.05)。结论 HPV感染是不良妊娠结局发生的危险因素,应加强HPV感染途径、危害和HPV疫苗接种的宣传教育及孕前、孕期筛查工作。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 of1679pregnant 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 was31.39%(527/1679),including14.23%(239/1679)of HR-HPV,15.54%(261/1679)of LR-HPV and1.61%(27/1679)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.

关 键 词：人乳头瘤病毒 妊娠期 妊娠结局 危险因素 

分 类 号：R714.2[医药卫生—妇产科学]