Xiong Yi-Quan, Mo Yun, Luo Qiao-Ming, Huo Shu-Ting, He Wen-Qiao, Chen Qing
Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, China.
Preventive Medicine (Health Inspection and Quarantine), School of Public Health, Southern Medical University, Guangzhou, China.
Gynecol Obstet Invest. 2018;83(5):417-427. doi: 10.1159/000482008. Epub 2018 Apr 12.
To estimate the impact of human papillomavirus (HPV) infection on spontaneous abortion, spontaneous preterm birth (sPTB), pregnancy rate of females undergoing assisted reproductive technologies (ART), and spontaneous abortion of ART pregnancy.
PubMed, Medline, Embase, and the Cochrane Library were searched until December 16, 2016. The OR or relative risk (RR) with its corresponding 95% CI were selected as effect size. Subgroup analysis of HPV genotype infection (high-risk HPV [HR-HPV] or indiscriminate genotype) was performed. Statistical analysis was conducted using STATA 12.0.
Eighteen studies were included. Eight studies revealed no significant association between HPV infection and spontaneous abortion (OR 1.40, 95% CI 0.56-3.50). However, subgroup analysis showed indiscriminate genotype HPV infection increased the ratio of spontaneous abortion with OR of 2.24 (95% CI 1.37-3.65), while HR-HPV infection had no significant effect (OR 0.65, 95% CI 0.21-1.98). The results indicated that HR-HPV infection was a risk for sPTB with a pooled OR of 2.84 (95% CI 1.95-4.14). HPV infection was found to be independent of the ART-based clinical pregnancy rate (RR 1.04, 95% CI 0.64-1.70) and spontaneous abortion of ART pregnancy (RR 1.47, 95% CI 0.86-2.50).
Indiscriminate HPV genotype infection can increase the risk of spontaneous abortion and HR-HPV infection was a risk factor for sPTB. However, there was not enough evidence to indicate the association between HPV infection and pregnancy rate of ART, and spontaneous abortion of ART pregnancy. Different genotypes of HPV infection may play a discrepant role in adverse pregnancy outcomes.
评估人乳头瘤病毒（HPV）感染对自然流产、自然早产（sPTB）、接受辅助生殖技术（ART）女性的妊娠率以及ART妊娠自然流产的影响。
检索截至2016年12月16日的PubMed、Medline、Embase和Cochrane图书馆。选择OR或相对风险（RR）及其相应的95%置信区间作为效应量。对HPV基因型感染（高危型HPV [HR-HPV]或非特异性基因型）进行亚组分析。使用STATA 12.0进行统计分析。
纳入18项研究。8项研究显示HPV感染与自然流产之间无显著关联（OR 1.40，95%置信区间0.56 - 3.50）。然而，亚组分析显示非特异性基因型HPV感染会增加自然流产率，OR为2.24（95%置信区间1.37 - 3.65），而HR-HPV感染无显著影响（OR 0.65，95%置信区间0.21 - 1.98）。结果表明，HR-HPV感染是sPTB的一个风险因素，合并OR为2.84（95%置信区间1.95 - 4.14）。发现HPV感染与基于ART的临床妊娠率（RR 1.04，95%置信区间0.64 - 1.70）以及ART妊娠自然流产（RR 1.47，95%置信区间0.86 - 2.50）无关。
非特异性HPV基因型感染会增加自然流产风险，HR-HPV感染是sPTB的一个风险因素。然而，没有足够证据表明HPV感染与ART妊娠率以及ART妊娠自然流产之间存在关联。不同基因型的HPV感染在不良妊娠结局中可能发挥不同作用。
