Impact of HPV infection on vaginal microecology and maternal and neonatal outcomes

Human papillomavirus (HPV) is a kind of spherical DNA virus, which is related to many factors such as immune status and pregnancy. Due to the decrease of immunity, pregnant women are more likely to have HPV infection, which causes serious imbalance of vaginal microecology and is not beneficial to pregnancy outcome. Therefore, this study focuses on the impact of HPV infection on vaginal microecology and maternal and neonatal outcomes.

A total of 140 pregnant women with HPV infection during pregnancy, who received obstetric examination in the First Affiliated Hospital of Hainan Medical College from November 2017 to July 2019, were selected as a HPV infection group, and 150 normal pregnant women with HPV negative in the same period were selected as a control group. Vaginal secretions were collected from all the pregnant women at 28-34 weeks of gestation to evaluate vaginal pH, cleanliness and microecological status, and to record pregnancy outcomes for all pregnant women.

The proportions of vaginal pH>4.5, constituent ratio of flora density and diversity of I-II, positive detection rate of vulvovaginal candidiasis (VVC) and bacterial vaginosis (BV) in HPV infected pregnant women were significantly higher than those in the control group (all P<0.05). There was no significant difference in vaginal cleanliness, dominant bacteria classification, detection rate of trichomonas vaginitis (TV), BV negative, and BV intermediate type between the 2 groups (all P>0.05). The incidence of microecological imbalance in pregnant women with HPV infection was significantly higher than that in the control group (P<0.05). There was no significant difference in natural delivery rate and cesarean section rate between the control group and the HPV infection group (P>0.05). The incidences of premature delivery, puerperal infection, postpartum hemorrhage, and chorioamnionitis in the HPV infection group were significantly higher than those in the control group (all P<0.05). There was no significant difference in the incidence of premature rupture of membranes between the 2 groups (P>0.05). The incidences of premature delivery, postpartum hemorrhage, and premature rupture of membranes of HPV-infected pregnant women in microecological imbalance group were significantly higher than those in the microecological normal group (all P<0.05). There was no significant difference in the incidences of puerperal infection and chorioamnionitis between the microecological normal group and the microecological imbalance group (all P>0.05).

Pregnant women with HPV infection during pregnancy are more likely to have vaginal microecological disorders, and can increase the risk of adverse pregnancy outcomes such as premature delivery and chorioamnionitis.