Медицинский совет (Oct 2020)
Cervical diseases in pregnant women. Socio-demographic and clinical-anamnestic risk factors
Abstract
Introduction. To study the prevalence of human papillomavirus infection, the frequency and structure of cervical diseases in pregnant women and determine the risk factors for their development.Material and methods. Screening for HPV was carried out among 2620 pregnant women. Of these, 682 (29%) had HPV. 182 pregnant women with HPV and 148 without HPV were included in the additional study program and were divided into groups depending on the presence or absence of cervical disease (CWD). The research methods were used: general clinical, the Kvant-21 test to determine HPV and STIs, microscopy of the vaginal discharge, determination of the composition of the vaginal microbiota by the Femoflor 16 method, cytological examination, extended colposcopy. We used the method of logit-regression models to identify risk factors.Results. The prevalence of diseases of the cervix (DC) in HPV carriers was 89.4%. 72.1% of them had inflammatory DC compared to 21.4% in patients without HPV (p < 0.0001). The incidence of intraepithelial lesions was 17.4% versus 2.6%, respectively (p = 0.005). The most significant risk factors for developing DC in pregnant women, in addition to HPV infection of high carcinogenic risk, are: Lack of regular screening for cervical cancer before pregnancy (OR = 34.8), a history of bacterial vaginosis (OR = 15.9), the practice of interrupted sexual intercourse during sexual contacts (OR = 14.6). Factors indicating a low risk of these diseases are: participation in the annual screening of cervical cancer, stable partnerships (one sexual partner, marriage), age under 25, and condom use (OR less than 0.25).Conclusion. The prevalence of DC in pregnant women against the background of HPV infection is high, predominantly inflammatory in nature and associated with certain socio-demographic and clinical-anamnestic risk factors.
Keywords
