[Clinical study on cervical intraepithelial neoplasia with high-risk HPV infection among pregnant women].

Objective: To investigate the relationship between cervical intraepithelial neoplasia (CIN) and high-risk (HR) HPV infection among late pregnant women.

Methods: From Aug. 2007 to Feb. 2010, 168 women at 13 to 32 gestational weeks undergoing prenatal examination in Beijing Obstetrics and Gynecology Hospital went through three stage cervical disease screening, including 21 women with cervicitis and 147 women with CIN (42 women with CIN III, 37 women with CIN II and 68 women with CIN I). Hybrid capture assay version II (HC-II) test was used to measure HR-HPV DNA load, and the logarithmic transtormation (log(10)) was performed. All 168 women were followed up to postpartum 3 - 6 months. HR-HPV infections rates of cervicitis and different CIN, the rate of HR-HPV infection turned naturally negative at postpartum of 3 to 6 months, and HR-HPV load at pregnancy and 3 - 6 months postpartum were observed.

Results: (1) HR-HPV infection rate: CIN III, II, I and cervicitis pregnant women's HR-HPV positive infection rates were 98% (41/42), 86% (32/37), 76% (52/68) and 62% (13/21) respectively, which reached statistical difference (P = 0.002). (2) HR-HPV naturally negative: the rate of pregnant women with different levels of CIN who turned HR-HPV naturally negative within 3 - 6 months of postpartum were CIN III 5% (2/41), CINII 47% (15/32), CINI52% (27/52) and cervicitis 10/13, which also reached statistical difference among those four groups (P = 0.000). (3) HR-HPV load: pregnant women with different grade of CIN and cervicitis HR-HPV DNA load were CIN III 2.02 ng/L(1.53, 2.67 ng/L), CINII 1.94 ng/L (0.75, 2.75 ng/L), CINI2.04 ng/L (0.08, 2.95 ng/L) and cervicitis 1.98 ng/L (-0.07, 2.47 ng/L). There was no significantly different HPV load in women with cervicitis and different CIN (P = 0.719). At 3 - 6 months postpartum, HR-HPV load was CIN III 1.55 ng/L (0.90, 2.10 ng/L), which was significantly higher than the amount of CINII 0.09 ng/L (-0.69, 1.74 ng/L), CINI0.48 ng/L (-0.56, 2.2 ng/L) and cervicitis -0.46 ng/L (-0.78, 1.40 ng/L, P = 0.036).

Conclusions: With the increasing of CIN grade, the rate of HR-HPV infection in pregnant women was increased, however, the rate of HR-HPV turning negative naturally at 3 - 6 months postpartum decreased. With different CIN grade during pregnancy, HR-HPV DNA load did not change significantly, but HR-HPV DNA load increased at 3 - 6 months of postpartum. HR-HPV DNA loads with the same grade of CIN and cervicitis during pregnancy higher than that of postpartum among pregnant women.