Папилломавирусная инфекция и неблагоприятные исходы беременности

Обзор включает данные за последние 20 лет о механизмах влияния вируса папилломы человека на течение беременности, а также о связи папилломавирусной инфекции с развитием выкидыша, преждевременных родов, задержки роста плода, преэклампсии и внутриутробной гибели плода. Рассмотрены актуальные данные об эффективности вакцинопрофилактики папилломавирусной инфекции в снижении риска неблагоприятных исходов беременности. При подготовке обзора проведен поиск публикаций в электронной базе данных PubMed, а также в научных электронных библиотеках eLIBRARY.RU и cyberleninka.ru. В обзор включены публикации, отобранные по ключевым словам «беременность», «исходы беременности» в сочетании с терминами «вирус папилломы человека» и «папилломавирусная инфекция». По данным критериям было отобрано 104 статьи. В анализ включались исследования, в которых оценивалась связь инфицирования вирусом папилломы человека с осложнениями беременности: преэклампсией, преждевременными родами, самопроизвольным выкидышем и др. Качественный анализ был направлен на оценку качества методологии, соответствие дизайна исследования поставленным задачам и убедительность выводов. По данным критериям было отобрано 48 статей; 23 статьи исключены в связи с высоким риском систематической ошибки, низкой или очень низкой убедительностью выводов, а также несоответствием критериям включения. Количественный анализ позволил учесть различия клиник и стран, в которых проводились исследования, и оценить статистическую значимость полученных результатов. Синтез данных позволил включить в анализ 22 статьи и исключить 11 публикаций в связи с их низкой репрезентативностью и недостаточной достоверностью представленных результатов. Для обоснования раздела «Введение» использованы 8 статей. Всего итоговый систематический обзор включает 70 публикаций, содержащих актуальные данные рандомизированных контролируемых исследований.

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