妊娠期妇女人细小病毒B19感染与异常流产及胎儿畸形关系的研究

Relationship between human parvovirus B19 infection and abnormal abortion and fetal malformation in pregnant women

目的分析妊娠期妇女感染人细小病毒B19(HPVB19)与异常流产及胎儿畸形的关系,为妊娠期妇女孕期保健随访方案制定提供参考,提升优生优育水平。方法选择2010年1月-2017年1月在我院行孕期保健、分娩符合纳入条件的的妊娠期孕妇608例。所有孕妇均于入组后行HPVB19筛查,将患者按照HPVB19筛查结果分为阳性组(118例)和阴性组(490例)。统计两组孕妇妊娠结局(异常流产率、剖宫产率、终止妊娠率、自然分娩剖宫产率)、新生儿妊娠结局(畸形率、死胎率、新生儿窒息率)并比较。统计HPVB19阳性孕妇筛查结果为阳性妊娠周期分布,不同妊娠周期检出HPVB19阳性孕妇及新生儿妊娠结局并比较。采用spearson相关性分析程序分析妊娠期妇女感染HPVB19与异常流产、胎儿畸形间的相关性。结果两组孕妇年龄、入组时孕周、体重、体质量指数(BMI)、孕次、产次比较差异无统计学意义(P>0.05)。所有产前即37-41w检出HPVB阳性孕妇,经治疗后,HPVB19IGM转阴。HPVB19阳性组孕妇异常流产率、剖宫产率、自然分娩转剖宫产率、终止妊娠率明显高于阴性组(P<0.05)。HPVB19阳性组孕妇新生儿胎儿宫内畸形率、新生儿畸形率、死胎率、新生儿窒息率均明显高于阴性组孕妇新生儿(P<0.05)。118例HPVB19阳性孕妇检出阳性孕周分布较为均匀。孕18-24w检出HPVB19阳性孕妇异常流产率即胎儿畸形率明显高于其它时段检出HPVB19阳性孕妇(P<0.05)。妊娠期妇女发生HPVB19感染与孕妇异常流产率、胎儿畸形间的相关性系数均>0.5,有较强的相关性。结论妊娠期妇女感染HPVB19与异常流产和胎儿畸形呈较高相关性,做好孕前筛查及健康宣教,孕期HPVB19筛查及相应对策,尽可能降低异常流产及胎儿畸形风险,提升优生优育水平具有重要意义。

Objective:To analyze the relationship between human parvovirus B19(HPVB19)and abnormal abortion and fetal malformation in pregnant women,and to provide reference for the development of pregnant women′s health followup program during pregnancy,and to improve the level of prenatal and postnatal care.Methods:A total of 608 pregnant women who were pregnant during pregnancy and delivery in our hospital from January 2010 to January 2017 were enrolled.All pregnant women were screened for HPVB19 after enrollment,and patients were divided into positive group(118 cases)and negative group(490 cases)according to HPVB19 screening results.The pregnancy outcomes(abnormal abortion rate,cesarean section rate,termination pregnancy rate,cesarean section rate of natural delivery),neonatal pregnancy outcome(abnormal rate,stillbirth rate,neonatal asphyxia rate)were compared and compared.The results of screening for HPVB19 positive pregnant women were positive pregnancy cycle distribution,and HPVB19 positive pregnant women and neonatal pregnancy outcomes were detected in different pregnancy cycles.Spearson correlation analysis program was used to analyze the correlation between HPVB19 infection and abnormal abortion and fetal malformation in pregnant women.Results:There was no significant difference in the age of the two groups,the gestational age,body weight,body mass index(BMI),pregnancy,and parity between the two groups(P>0.05).HPVB-positive pregnant women were detected at 37-41 weeks before delivery,and HPVB19 IGM turned negative after treatment.The abnormal abortion rate,cesarean section rate,natural delivery rate and cesarean section rate and termination pregnancy rate in the HPVB19 positive group were significantly higher than those in the negative group(P<0.05).In the HPVB19 positive group,the intrauterine malformation rate,neonatal malformation rate,stillbirth rate and neonatal asphyxia rate were significantly higher than those in the negative group(P<0.05).The positive gestational age of 118 HPVB19 positive pregnant women was more evenly distributed.The abnormal abortion rate of the HPVB19 positive pregnant women,ie the fetal malformation rate,was significantly higher than that of other pregnant women with HPVB19 positive(P<0.05).The correlation coefficient between HPVB19 infection and abnormal abortion rate and fetal malformation in pregnant women was>0.5,which had a strong correlation.Conclusion:HPVB19 infection in pregnant women is associated with abnormal abortion and fetal malformation.Pre-pregnancy screening and health education,HPVB19 screening during pregnancy and corresponding countermeasures are adopted to minimize the risk of abnormal abortion and fetal malformation,and to improve the level of prenatal and postnatal care.It is of great significance.