Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil; Departamento Materno Infantil, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, MG, Brazil.
Divisão de Clínica Obstétrica, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2022 Oct 31;77:100127. doi: 10.1016/j.clinsp.2022.100127. eCollection 2022.
The authors aim to carry out an investigation on the impact of cervical oncogenic Human Papillomavirus (HPV) detection in pregnant adolescents, to clarify the prevalence and risk factors, considering the importance and lack of data on this topic in Brazil.
A cross-sectional study was conducted with adolescents receiving prenatal care in a tertiary hospital in São Paulo, Brazil, with routine Pap smear and oncogenic HPV detection test in the uterine cervix. The authors sought to associate the results of these tests with demographic and obstetric variables.
A total of 303 pregnant adolescents whose mean age was 15.30 ± 1.22 years comprised the study subjects. The frequency of high-risk HPV cervical detection was 50.50%. Multivariate analysis revealed that a large number of partners in their lifetime (OR = 1.27) and having a religion (OR = 2.05) were risk factors for cervical detection of oncogenic HPV, while schooling appeared as a protective factor (OR = 0.85). There was an association between this detection and colpocytological alterations, reaching almost 30% of patients, but without association with obstetric and neonatal outcomes.
The prevalence found is one of the highest in Brazil and worldwide. A greater number of partners during their lifetime and having religion were detected as possible factors associated with cervical HPV detection. Detection of cervical HPV-DNA did not influence obstetric and neonatal outcomes. The findings of this study reinforce the need to implement educational measures capable of modifying the incidence of sexually transmitted infections in this population and capable of promoting adherence to HPV vaccination programs.
作者旨在对青少年孕妇的人乳头瘤病毒（HPV）致癌性检测的影响进行调查，以阐明其流行率和危险因素，因为这一主题在巴西的重要性和缺乏数据。
这是一项在巴西圣保罗的一家三级医院进行的青少年产前护理的横断面研究，对子宫颈进行常规巴氏涂片和致癌 HPV 检测。作者试图将这些检测结果与人口统计学和产科变量相关联。
共纳入 303 名平均年龄为 15.30±1.22 岁的青少年孕妇作为研究对象。高危型 HPV 宫颈检测阳性率为 50.50%。多变量分析显示，一生中伴侣数量较多（OR=1.27）和有宗教信仰（OR=2.05）是宫颈癌前病变发生的危险因素，而受教育程度是保护因素（OR=0.85）。该检测与阴道细胞学改变有关，接近 30%的患者发生改变，但与产科和新生儿结局无关。
本研究中的 HPV 感染率是巴西乃至全球最高的。一生中伴侣数量较多和有宗教信仰被认为是与 HPV 检测相关的可能因素。HPV-DNA 检测并未影响产科和新生儿结局。本研究的结果强调了实施教育措施的必要性，以减少该人群中性传播感染的发生率，并促进 HPV 疫苗接种计划的实施。
