孕期高危型人乳头瘤病毒的流行病学特征及对妊娠结局的影响

doi:10.3969/j.issn.1006-7795.2018.06.009

首都医科大学学报 ›› 2018, Vol. 39 ›› Issue (6): 836-840.doi: 10.3969/j.issn.1006-7795.2018.06.009

• 生殖道HPV感染与宫颈病变 • 上一篇下一篇

孕期高危型人乳头瘤病毒的流行病学特征及对妊娠结局的影响

黄文阳¹, 何鑫¹, 李卫华¹, 张雪芳¹, 李湛¹, 谷丽², 路军丽¹, 王淑珍¹

1. 首都医科大学附属北京朝阳医院妇产科, 北京 100020;
2. 首都医科大学附属北京朝阳医院感染与微生物科, 北京 100020

收稿日期:2018-09-30 出版日期:2018-11-21 发布日期:2018-12-19
通讯作者: 王淑珍 E-mail:darrywang2003@163.com
基金资助:
国家自然科学基金青年科学基金项目（81702551）。

Epidemiological characteristics of high-risk human papillomavirus infection during pregnancy and the correlation between the high-risk human papillomavirus infection and the pregnancy outcomes

Huang Wenyang¹, He Xin¹, Li Weihua¹, Zhang Xuefang¹, Li Zhan¹, Gu Li², Lu Junli¹, Wang Shuzhen¹

1. Department of Gynaecology and Obstetrics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China;
2. Department of Infection and Microbiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China

Received:2018-09-30 Online:2018-11-21 Published:2018-12-19
Supported by:
This study was supported by National Natural Science Foundation Youth Science Fund Project (81702551).

摘要/Abstract

摘要： 目的探讨妊娠妇女孕期高危型人乳头瘤病毒（high risk-human papillomavirus， HR-HPV）的流行病学特征及其对妊娠结局的影响。方法采用平行对照研究的方法，对首都医科大学附属北京朝阳医院2013年3月至2017年12月间建立孕产妇保健档案并接受HR-HPV 检查的3 967例孕妇，与同期、同年龄的非孕妇按照1∶3配对，分析孕期HR-HPV感染的流行病学特征，采用队列研究的方法分析孕期HR-HPV感染对妊娠结局的影响。结果孕期HR-HPV的总感染率、多重混合感染、高病毒载量感染分布低于非孕期（P<0.05），型别分布与非孕期差异无统计学意义（P>0.05）。孕期HR-HPV感染率与年龄无明显相关性。HR-HPV感染的孕妇羊水过少发生率增高，急产发生率降低，差异有统计学意义（P<0.05）。结论孕期HR-HPV感染不增加除羊水过少外其他不良妊娠结局的危险，孕期HR-HPV感染率及严重程度均低于非孕期女性。

关键词: 高危型人乳头瘤病毒, 妊娠, 流行病学, 妊娠结局

Abstract: Objective To investigate the epidemiological characteristics of high-risk human papillomavirus(HR-HPV) in pregnant women during pregnancy and its effect on pregnancy outcomes. Methods From March 2013 to December 2017, a total of 3 967 pregnant women who established maternal health records and received HR-HPV examinations,1:3 paired non-pregnant women of the same age and the same period,were selected to investigate the epidemiological characteristics of HR-HPV infection during pregnancy by parallel controlled study, and to investigate the impact of HR-HPV infection on pregnancy outcome by Cohort study. Results The total infection rate, multiple mixed infection and high viral load of HR-HPV in pregnant women were lower than those in non-pregnant women (P<0.05). There was no significant correlation between the HR-HPV infection rate and age in pregnant women.For pregnant women with HR-HPV infection,the incidence of oligohydramnios increased while the incidence of acute labor decreased, and the differences were statistically significant (P<0.05). Conclusion HR-HPV infection during the pregnancy does not increase the risk of other adverse pregnancy outcomes except for oligohydramnios. The rate and severity of HR-HPV infection in the pregnancy women were lower than that in non-pregnancy women, which is inconsistent with most international data. It may be related to the significant decline in the sexual activities frequency of Chinese pregnant women.

Key words: high-risk human papillomavirus, pregnancy, epidemiology, pregnancy outcome

中图分类号:

R714.25

黄文阳, 何鑫, 李卫华, 张雪芳, 李湛, 谷丽, 路军丽, 王淑珍. 孕期高危型人乳头瘤病毒的流行病学特征及对妊娠结局的影响[J]. 首都医科大学学报, 2018, 39(6): 836-840.

Huang Wenyang, He Xin, Li Weihua, Zhang Xuefang, Li Zhan, Gu Li, Lu Junli, Wang Shuzhen. Epidemiological characteristics of high-risk human papillomavirus infection during pregnancy and the correlation between the high-risk human papillomavirus infection and the pregnancy outcomes[J]. Journal of Capital Medical University, 2018, 39(6): 836-840.

参考文献

[1] Romero R, Espinoza J, Kusanovic J P, et al. The preterm parturition syndrome[J]. BJOG, 2006, 113(Suppl 3):17-42.
[2] Donati L, Di Vico A, Nucci M, et al. Vaginal microbial flora and outcome of pregnancy[J]. Arch Gynecol Obstet, 2010,281(4):589-600.
[3] Chesson H W, Dunne E F, Hariri S, et al. The estimated lifetime probability of acquiring human papillomavirus in the United States[J]. Sex Transm Dis, 2014, 41(11):660-664.
[4] Boulenouar S, Weyn C, Van Noppen M, et al. Effects of HPV-16 E5, E6 and E7 proteins on survival, adhesion, migration and invasion of trophoblastic cells[J]. Carcinogenesis, 2010,31(3):473-480.
[5] You H, Liu Y, Agrawal N, et al. Multiple human papillomavirus types replicate in 3A trophoblasts[J]. Placenta, 2008,29(1):30-38.
[6] Hong L J, Oshiro B T, Chan P J. HPV-16 exposed mouse embryos:a potential model for pregnancy wastage[J]. Arch Gynecol Obstet, 2013,287(6):1093-1097.
[7] Henneberg A A, Patton W C, Jacobson J D, et al. Human papilloma virus DNA exposure and embryo survival is stage-specific[J]. J Assist Reprod Genet, 2006,23(6):255-259.
[8] Liu P, Xu L, Sun Y, et al. The prevalence and risk of human papillomavirus infection in pregnant women[J]. Epidemio Infect, 2014,142(8):1567-1578.
[9] Ambühl L M, Baandrup U, Dybkær K, et al. Human papillomavirus infection as a possible cause of spontaneous abortion and spontaneous preterm delivery[J]. Infect Dis Obstetr Gynecol, 2016, 2016(9):3086036.
[10] 张丽敏, 方芳, 陈柯霖, 等. 妊娠及体检妇女宫颈感染人乳头瘤病毒基因分型检测特征分析[J]. 中国实验诊断学, 2018, 22(2):265-268.
[11] 王晶,赖薇. 200例孕妇的孕期性观念及性生活现状调查[J]. 预防医学情报杂志, 2017, 33(2):195-197.
[12] Martin D H, Marrazzo J M. The vaginal microbiome:current understanding and future directions[J]. J Infect Dis, 2016, 214(Suppl 1):S36-S41.
[13] Brotman R M, He X, Gajer P, et al. Association between cigarette smoking and the vaginal microbiota:a pilot study[J]. BMC Infect Dis, 2014, 14(1):471.
[14] Boskey E R, Cone R A, Whaley K J, et al. Origins of vaginal acidity:high d/l lactate ratio is consistent with bacteria being the primary source[J]. Human Reprod, 2001, 16(9):1809-1813.
[15] Slatter T L, Hung N G, Clow W M, et al. A clinicopathological study of episomal papillomavirus infection of the human placenta and pregnancy complications[J]. Mod Pathol, 2015, 28(10):1369-1382.

孕期高危型人乳头瘤病毒的流行病学特征及对妊娠结局的影响

Epidemiological characteristics of high-risk human papillomavirus infection during pregnancy and the correlation between the high-risk human papillomavirus infection and the pregnancy outcomes

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