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人乳头瘤病毒感染作为孕早期流产的潜在原因:一项前瞻性研究。

Papillomavirus Infection as Potential Cause of Miscarriage in the Early Gestational Age: A Prospective Study.

作者信息

Bruno Maria Teresa, Caruso Salvatore, Scalia Guido, Costanzo Maria, Di Pasqua Salvatore, Boemi Sara, Panella Marco Marzio, Palumbo Marco

机构信息

Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy.

Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, Italy.

出版信息

Diagnostics (Basel). 2023 May 8;13(9):1659. doi: 10.3390/diagnostics13091659.

Abstract

The possible association between human papillomavirus (HPV) infection and negative pregnancy outcomes has been debated in the literature, with conflicting results from clinical trials. While some authors support a link between HPV and miscarriage, others argue that the mere detection of the virus does not necessarily indicate a causal relationship with negative pregnancy outcomes. In this study, we conducted a prospective, controlled investigation of the potential association between HPV infection and miscarriage. Our study included 59 women who had experienced a miscarriage and 57 women who had undergone voluntary termination of pregnancy (TOP) within the 12th week of gestation. We assessed HPV prevalence, maternal age, and HPV genotype in both groups and evaluated the relationship between these factors and pregnancy outcome. Unlike previous studies that only identified HPV in cases of abortion, we also correlated the positivity of chorionic villi with gestational age in both groups. We found a close correlation between positive chorionic villi and very early gestational age, with all 13 cases of virus-positive chorionic villi in the miscarriage group occurring in gestational periods of less than 8 + 5 weeks (<60 days) (RR = 28.6). Our analysis showed no correlation between HPV infection and maternal age or viral genotypes. The results suggest that the presence of HPV alone is not enough to cause spontaneous abortion, but a high viral load in early pregnancy may increase the risk of negative outcomes. These findings have important implications for the management of HPV infection during pregnancy and may provide a rationale for the use of HPV vaccines to reduce the incidence of spontaneous abortion and infertility due to preclinical spontaneous abortions.

摘要

人乳头瘤病毒(HPV)感染与不良妊娠结局之间的潜在关联在文献中一直存在争议,临床试验结果相互矛盾。一些作者支持HPV与流产之间存在联系,而另一些人则认为仅仅检测到该病毒并不一定表明与不良妊娠结局存在因果关系。在本研究中,我们对HPV感染与流产之间的潜在关联进行了一项前瞻性对照调查。我们的研究纳入了59名经历过流产的女性和57名在妊娠12周内接受自愿终止妊娠(TOP)的女性。我们评估了两组中的HPV患病率、产妇年龄和HPV基因型,并评估了这些因素与妊娠结局之间的关系。与以往仅在流产病例中鉴定出HPV的研究不同,我们还将两组中绒毛膜绒毛的阳性情况与孕周进行了关联。我们发现绒毛膜绒毛阳性与极早期孕周密切相关,流产组中所有13例病毒阳性的绒毛膜绒毛病例均发生在小于8 + 5周(<60天)的孕周(RR = 28.6)。我们的分析表明,HPV感染与产妇年龄或病毒基因型之间无相关性。结果表明,仅HPV的存在不足以导致自然流产,但妊娠早期的高病毒载量可能会增加不良结局的风险。这些发现对孕期HPV感染的管理具有重要意义,并可能为使用HPV疫苗以降低自然流产和临床前自然流产导致的不孕症的发生率提供理论依据。

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本文引用的文献

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