HPV Infection And Pregnancy-related Diseases: A Meta-analysis

Objective:Due to changes in hormone levels in pregnant women during pregnancy,immune function is suppressed,and the ability of human papillomavirus(HPV)clearance is weakened.This study aims to explore the relationship between HPV infection and pregnancy-related diseases,so as to provide evidence for clinical prevention,diagnosis and treatment.Methods:The relevant literatures on HPV infection and pregnancy-related diseases published before December 2020 in Pub Med,Embase,Cochrane Library,CNKI,Wanfang,VIP and other databases were retrieved.The literatures were filtered by Endnote X9 according to the inclusion and exclusion criteria,and the quality of the included literatures was assessed using the Newcastle-Ottawa Scale(NOS),a quality evaluation Scale for non-randomized controlled clinical trials.The software Rev Man5.3 was used to process the data and complete the Meta-analysis of the included literatures.Oddness ratios(OR)were assessed using random-effects models and heterogeneity was assessed using I2 statistics.Results:1.In our study,there are 74 literatures included,including60 cohort studies and 14 case-control studies.Among them,7literatures were related to HPV infection during pregnancy and non-pregnancy;there were 25 literatures related to preterm birth,with a sample size of 386,387 people.There were 21 literatures related to premature rupture of membranes,with a sample size of256132 persons.There were 4 articles related to neonatal low birth weight,with a sample size of 360,702 persons.There were 2papers related to ectopic pregnancy with a sample size of 265 persons.There were 15 papers related to IVF,with a sample size of 2974 people.2.There was no significant difference in HPV infection between pregnant and non-pregnant women of childbearing age.Random-effects model was used to combine effect sizes,and the results showed that OR=1.03,95%CI =0.69 ～ 1.56,P>0.05,indicating that there was no statistical significance between the two groups.3.HPV infection was positively associated with the risk of preterm birth.The fixed effect model was used to combine effect size,and the results showed that OR=1.44,95%CI = 1.29-1.61,P< 0.05,indicating that the difference between the two groups was statistically significant.4.High-risk HPV infection is associated with an increased risk of premature rupture of membranes.The fixed effect model was used to combine effect size,and the results showed that OR=1.77,95%CI =1.52 ～ 2.05,P < 0.05,and the difference between the two groups was statistically significant.5.HPV infection is associated with an increased risk of low birth weight.The random-effects model was used to combine effect sizes,and the results showed that OR=1.88,95%CI =1.27-2.76,P=0.001 < 0.05,indicating that the difference between the two groups was statistically significant.6.High-risk HPV infection is associated with an increased risk of ectopic pregnancy.The fixed effect model was used to combine effect size,and the results showed that OR=5.76,95%CI= 2.76-11.99,P < 0.05,and the difference between the two groups was statistically significant.7.There was no correlation between high-risk HPV infection and IVF clinical pregnancy rate.Fixed effect model was used to combine effect size,and the results showed that OR=0.98,95%CI=0.79 ～ 1.22,P=0.85>0.05,indicating that there was no statistical significance between the two groups.Conclusion:The findings suggest that there was no significant difference in HPV infection between pregnant women and non-pregnant women of childbearing age.HPV infection is associated with an increased risk of premature birth;HPV infection may be a factor in the increased risk of low birth weight;High-risk HPV infection was positively associated with an increased risk of premature rupture of membranes.High-risk HPV infection may be a factor in the increased risk of ectopic pregnancy;High-risk HPV infection did not affect clinical pregnancy rates in IVF patients.Despite this conclusion,given the objective limitations of the small number of studies included,further studies are needed to confirm this conclusion.