高龄产妇产褥期HPV高危型感染的危险因素Logistic回归分析及预防建议

Logistic regression analysis of risk factors of HPV high-risk infection in puerperal women of advanced age and prevention suggestions

目的探讨高龄产妇产褥期人乳头瘤病毒(HPV)高危型感染的相关危险因素,并提出预防建议。方法回顾性分析2016年1月至2018年5月东莞市人民医院120例高龄产妇的临床病历资料,根据产褥期是否发生HPV高危型感染情况将其分为感染组与未感染组,并采用单因素和多因素Logistic回归分析法分析影响高危型HPV感染的相关危险因素,并提出预防建议。结果 120例高龄产妇产后42 d检查发现有21例发生HPV高危型感染,感染发生率为17.50%;感染组孕次>1次、产次>1次、有妊娠期合并症、早产及剖宫产的构成比与未感染组比较差异均无统计学意义(均P>0.05);感染组有人工流产史、产后阴道清洁度Ⅲ~Ⅳ度、产褥期不良卫生习惯、产褥期被动吸烟、产褥期接触过被HPV污染的物品、伴侣有HPV感染、农村居民及专科以下学历的构成比均明显高于未感染组,且经Logistic回归分析发现其均是高龄产妇产褥期HPV高危型感染的危险因素(OR=4.027、5.489、4.726、3.662、5.842、5.291、4.323、3.894,均P<0.05)。结论人工流产史、产后阴道清洁度Ⅲ~Ⅳ度、产褥期不良卫生习惯、产褥期被动吸烟、有HPV接触史、农村居民及文化程度低均是高龄产妇产褥期HPV高危型感染的危险因素,临床工作者需加强对此类产妇的监管。

Objective To explore the risk factors of high-risk human papillomavirus(HPV) infection in puerperal women of advanced age and provide prevention suggestions. Methods The clinical data of 120 parturient women of advanced age in our hospital from January 2016 to May 2018 were retrospectively analyzed. The women were divided into infection group or non-infection group according to whether or not having HPV high-risk infection in puerperium, then the risk factors of high-risk HPV infection were analyzed using single factor analysis and multiple factor logistic regression analysis, and suggestions for prevention were put forward. Results There were 21 cases of HPV high-risk infection among the 120 parturient women 42 days after giving birth;the infection rate was 17.50%. There was no significant difference in the constituent ratios of the pregnancy times >1, delivery times >1, pregnancy complications, premature delivery and cesarean section between the infection group and non-infection group(all P>0.05). The constituent ratios of history of induced abortion, III-IV postpartum vaginal cleanliness, bad hygiene habits during puerperium, passive smoking during puerperium, contacted with articles contaminated by HPV during puerperium, partners with HPV infection, rural residents and education below junior college in the infection group were significantly higher than those in the non-infection group, and Logistic regression analysis showed that they were the risk factors of high-risk HPV infection in parturient women of advanced age in puerperal period(OR=4.027, 5.489, 4.726, 3.662, 5.842, 5.291, 4.323, 3.894, all P<0.05). Conclusion Induced abortion history, postpartum vaginal cleanliness III-IV, bad hygienic habits during puerperium, passive smoking during puerperium, HPV contact history, rural residents and low educational level are the risk factors of high-risk HPV infection in the puerperium in parturient women of advanced age, and clinicians need to strengthen the monitoring on parturient women of advanced age.