METHODS: The retrospective observational cohort study was divided into two parts. Part I evaluated the genotype distribution and prevalence of HR-HPV. It encompassed 6285 pregnant women who underwent a routine pregnancy check-up, Thin Prep cytology test (TCT), and HR-HPV diagnosis during weeks 12-14 of gestation between January 1, 2013, and December 31, 2021. Part II analyzed the association between HR-HPV infection and maternal-fetal pregnancy outcome. Through a nearest-neighbor 1:1 propensity score matching (PSM), we matched HR-HPV-positive and HR-HPV-negative pregnant women using caliper width equal to 0.02. After PSM, 171 HR-HPV-positive and 171 HR-HPV-negative pregnant women were included to analyze the association between HR-HPV infection and maternal-fetal pregnancy outcome.
RESULTS: In total 737 (11.73%) pregnant women were HR-HPV positive. The five most common genotypes of HR-HPV were HPV-52 (2.90%), HPV-58 (2%), HPV-16 (1.94%), HPV-51 (1.38%), and HPV-39 (1.29%). As for age-specific HPV prevalence, a \"U-shaped\" pattern was observed. The first and second peaks were detected in pregnant females aged <25 years and those aged ≥35 years, respectively. Our study found no significant difference between the HR-HPV-positive and the HR-HPV-negative pregnant females in the following maternal-fetal pregnancy outcomes: spontaneous abortion (1.2% for HR-HPV positive, 0% for HR-HPV negative, p = 0.478), preterm delivery (4.7% for HR-HPV positive, 5.3% for HR-HPV negative, p = 0.804), premature rupture of membrane (28.8% for HR-HPV positive, 22.8% for HR-HPV negative, p = 0.216), preeclampsia (7.6% for HR-HPV positive, 7.6% for HR-HPV negative, p = 1), oligohydramnios (8.2% for HR-HPV positive, 7% for HR-HPV negative, p = 0.683), fetal growth restriction (1.8% for HR-HPV positive, 0.6% for HPV negative, p = 0.615), placenta previa (1.2% for HR-HPV positive, 0.6% for HR-HPV negative, p = 1), postpartum hemorrhage (8.9% for HR-HPV positive, 11.2% for HR-HPV negative, p = 0.47). There was also no significant difference in delivery mode or birth weight between the two groups.
CONCLUSIONS: HPV-16, 52, and 58 were the most prevalent infection genotypes in pregnant females. The study showed no significant differences between HR-HPV-positive and HR-HPV-negative groups in the maternal-fetal pregnancy outcomes.
方法:回顾性观察性队列研究分为两部分。第一部分评估了HR-HPV的基因型分布和患病率。它包括6285名接受常规妊娠检查的孕妇,薄层细胞学检查(TCT),2013年1月1日至2021年12月31日期间妊娠12-14周的HR-HPV诊断。第二部分分析了HR-HPV感染与母胎妊娠结局之间的关系。通过最近邻1:1倾向得分匹配(PSM),我们使用卡尺宽度等于0.02对HR-HPV阳性和HR-HPV阴性孕妇进行匹配.PSM之后,纳入171例HR-HPV阳性和171例HR-HPV阴性孕妇,以分析HR-HPV感染与母胎妊娠结局之间的关系。
结果:总共737名(11.73%)孕妇中HR-HPV阳性。HR-HPV最常见的5种基因型为HPV-52(2.90%),HPV-58(2%),HPV-16(1.94%),HPV-51(1.38%),HPV-39(1.29%)。至于年龄特异性HPV患病率,观察到“U形”模式。在年龄<25岁和年龄≥35岁的孕妇中检测到第一和第二峰,分别。我们的研究发现,在以下母胎妊娠结局中,HR-HPV阳性和HR-HPV阴性孕妇之间没有显着差异:自然流产(HR-HPV阳性为1.2%,HR-HPV阴性为0%,p=0.478),早产(HR-HPV阳性的4.7%,HR-HPV阴性5.3%,p=0.804),胎膜早破(HR-HPV阳性28.8%,HR-HPV阴性的22.8%,p=0.216),先兆子痫(HR-HPV阳性为7.6%,HR-HPV阴性为7.6%,p=1),羊水过少(HR-HPV阳性为8.2%,7%为HR-HPV阴性,p=0.683),胎儿生长受限(HR-HPV阳性1.8%,0.6%的HPV阴性,p=0.615),前置胎盘(HR-HPV阳性1.2%,HR-HPV阴性0.6%,p=1),产后出血(HR-HPV阳性为8.9%,HR-HPV阴性11.2%,p=0.47)。两组的分娩方式和出生体重也没有显着差异。
结论:HPV-16、52和58是妊娠女性中最普遍的感染基因型。该研究显示HR-HPV阳性组和HR-HPV阴性组在母胎妊娠结局方面没有显着差异。