孕妇人乳头瘤病毒持续感染与生殖道微生物水平及不良妊娠结局关系

Correlation between the persistent human papillomavirus infection of puerperae and their reproductive tract microbial level and adverse pregnant outcomes

目的:探究孕妇人乳头瘤病毒(HPV)持续感染与生殖道微生物水平及母婴结局的关系。方法:以2019年1月-2021年1月在本院产前检查的产妇460例为研究对象,其中HPV感染105例,未感染HPV 355例,感染HPV患者中,高危(HR)-HPV感染50例,非HR-HPV感染55例,比较未感染HPV组、HR-HPV组以及非HR-HPV组阴道微生物以及妊娠结局的差异,分析HPV与HR-HPV感染与阴道菌群以及妊娠结局的相关性。结果:未感染HPV组、HR-HPV组及非HR-HPV组阴道菌群密集度、阴道菌群的多样性以及微生态情况有差异。感染HPV组发生早产、胎膜早破、胎儿生长受限以及呼吸窘迫综合征率高于未感染HPV组。通过相关性分析,HPV以及HR-HPV感染与感染者阴道菌群密集度、阴道菌群多样性、微生态、早产、胎膜早破、胎儿生长受限以及呼吸窘迫综合征均呈正相关(P<0.05)。结论:HPV持续感染与产妇生殖道微生物水平及母婴不良结局呈显著相关性,建议孕产妇定期进行HPV检测。

Objective:To study the correlation between the persistent human papillomavirus(HPV)infection of puerperae and their reproductive tract microbial level and their maternal and infant adverse pregnant outcomes.Methods:460 puerperae who had undergone antenatal examination from J anuary 2019 to January 2021 were selected as the research objects,and which including 105 puerperae with HPV infection in group A and 355 puerperae without HPV infection in group B.In group A,50 puerperae with HR-HPV in group A1 and 55 puerperae with other HPV in group A2.The differences of vaginal microorganisms and the pregnancy outcomes of the puerperae were compared between group A and group B,and between group A1 and group A2.The correlation between the HPV and HR HPV infections of the puerperae and their vaginal flora and pregnancy outcomes was analyzed.Results:There were significant differences in the intensity,diversity,and microecology of vaginal flora of the puerperae among group B,group A1,and group A2.The incidences of premature delivery,the premature rupture of membranes,and the fetal growth restriction and respiratory distress syndrome of the puerperae in group A were significantly higher than those of the puerperae in group B.Correlation analysis showed that the HPV and HR-HPV infection of the puerperae were positively correlated with their intensity,diversity,and microecology of vaginal flora,the preterm birth,the premature rupture of membranes,and the fetal growth restriction and the respiratory distress syndrome(P<0.05).Conclusion:The persistent HPV infection of the puerperae is correlation with their reproductive tract microbial level and their maternal and infant out-comes significantly.It is suggested that maternal HPV testing of the puerperae should be carried out regularly.