妊娠晚期HPV潜伏感染对妊娠的影响分析

Impact of HPV latent infection on the third trimester of pregnancy

目的:探究妊娠晚期人乳头瘤病毒(Human papilloma virus,HPV)潜伏感染对妊娠结局的影响。方法:选取我院2005年9月～2011年3月间收治的孕期28周以上孕妇共467例,进行HPV检测,根据检测结果将其分为感染组与对照组,观察两组孕妇的妊娠结局,并探讨影响因素。结果:共有213例孕妇检出HPV阳性,HPV感染率高达45.6%;感染组产妇顺产115例(54.0%),剖宫产79例(37.1%),产钳助产19(8.9%)例,均为单胎生产,新生儿出现呼吸道乳头瘤2例(0.9%),携带HPV病毒74例(34.7%);对照组产妇顺产177例(69.7%),剖宫产69例(27.2%),产钳助产8例(3.1%),新生儿未出现呼吸道乳头瘤及携带HPV等症状;HPV感染组患者文化水平较低(OR 6.837,95%CI 1.526-3.237)、首次性生活年龄较小(OR 7.942,95%CI 1.368-17.305)且有吸烟史(OR 5.352,95%CI 2.262-17.485),而首次怀孕年龄非影响妊娠晚期HPV感染的危险因素。结论:妊娠晚期HPV感染对妊娠结局有着不良影响,而文化水平、首次性生活年龄及吸烟史是影响妇女HPV感染的高危因素,应普及HPV相关知识,从根源上控制HPV感染,提高人口质量。

Objectives： To explore the impact of human papilloma virus （HPV） latent infection on the third trimester of pregnancy. Methods： We selected 467 pregnant women whose pregnancy is over 28 weeks in our hospital from September 2005 to March 2011 and conducted HPV detection tests on them. According to the results of detection, they are divided into infection group and control group. By observing their pregnancy outcome, we analyzed the influencing factors. Results： 213 cases of the pregnant women are detected to be HPV positive, and HPV infection rate reaches as high as 45.6%. In the infection group, 115 cases have natural childbirth （ 54.0% ） and 79 cases have cesarean section （ 37.1% ）, 19 cases have forceps delivery （ 8.9% ）, all of whom produced single births. Among the neonates, there are 2 cases （0.9%） and 74 cases carrying the HPV symptoms （ 34.7% ）. In the control group, 117 cases have natural childbirth and 69 eases have cesarean section, 8 cases got forceps delivery. There are no respiratory papilloma newborns in the control group. In the HPV infection group, patients had low education level （ OR 6. 837, 95% CI 1. 526 -3. 237 ）, earlier first sex age （ OR 7.942, CI 1. 368 - 17. 305 95% ） and a his- tory of smoking （ OR 5. 352, 95% CI 2. 262 - 17.485 ） while the first time gestation age was not an influencing factor of HPV infection. Conclusion： HPV infection in the third trimester pregnancy has adverse effects on pregnancy outcome. Education lev- el, the first sex age and smoking history can be high risk factors of HPV infection. The knowledge of HPV should be publicized and HPV infection should be prevented to improve people＇s life quality.