Centro de Investigaciones Regionales, Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico.
Eur J Obstet Gynecol Reprod Biol. 2013 Oct;170(2):468-73. doi: 10.1016/j.ejogrb.2013.07.002. Epub 2013 Jul 30.
To investigate if HPV cervical infection is associated with spontaneous abortion in a Mexican population.
Case control study including 281 women from two Social Security Hospitals in Merida, Mexico. Cases were women with spontaneous abortion attending for curettage, and controls were pregnant women at term who attended for delivery. HPV molecular detection and typing of HPV 16, 18, 58 and 6/11 was performed on cervical samples, and TORCH serology IgM tests (against T. gondii, CMV, HSV) were performed on cases. Data were analyzed using Chi square, odds ratio and linear regression tests.
HPV global prevalence was 19.8% (24.4% in cases and 15.2% in controls). HPV types 16 and 58 were the most frequently detected in both groups. Multiple HPV types concurrent infection were found in 31.4% of typified samples. Amongst cases 27.3% of HPV positive women reported at least one previous pregnancy loss; compared to 17.43% amongst HPV negative women. Nevertheless, HPV was not significantly associated with spontaneous or to repetitive abortion. Cases were 60.2% positive to any TORCH agent, although it was not significantly associated to referred miscarriage history. Spontaneous abortion was associated to a previous pregnancy loss and to women's age older than 35 years old. HPV infection was significantly associated to alcohol intake before pregnancy and to multiple sexual partners.
HPV cervical infection was not associated with spontaneous abortion. HPV in spontaneous abortion and other adverse pregnancy outcomes merits further study.
研究 HPV 宫颈感染是否与墨西哥人群中的自然流产有关。
本病例对照研究纳入了来自墨西哥梅里达两家社会保障医院的 281 名女性。病例为因刮宫术就诊的自然流产妇女，对照组为足月妊娠就诊分娩的孕妇。对宫颈样本进行 HPV 分子检测和 HPV 16、18、58 和 6/11 型别分型，并对病例进行 TORCH 血清学 IgM 检测（针对弓形虫、CMV、HSV）。使用卡方检验、优势比和线性回归检验分析数据。
HPV 总流行率为 19.8%（病例组为 24.4%，对照组为 15.2%）。两组中最常检测到的 HPV 类型为 16 型和 58 型。在已分型的样本中，31.4%存在多种 HPV 型别同时感染。在 HPV 阳性的病例中，27.3%的女性报告至少有一次既往妊娠丢失；而在 HPV 阴性的女性中，这一比例为 17.43%。然而，HPV 与自然流产或复发性流产并无显著相关性。27.3%的病例对任何 TORCH 病原体均呈阳性，尽管与流产史无关。自然流产与既往妊娠丢失以及女性年龄大于 35 岁有关。HPV 感染与妊娠前饮酒和多个性伴侣显著相关。
HPV 宫颈感染与自然流产无关。HPV 在自然流产和其他不良妊娠结局中的作用值得进一步研究。
