Beckers Kirsten, Schaad Urs B, Heininger Ulrich
Department of Internal Medicine, Spital Zofingen, Zofingen, Switzerland.
Eur J Pediatr. 2004 Nov;163(11):654-7. doi: 10.1007/s00431-004-1522-x. Epub 2004 Aug 17.
The goal of this study was to determine compliance with official recommendations for prevention of perinatal hepatitis B virus transmission from hepatitis B surface antigen (HBsAg) positive mothers to their offspring. All infants born to HBsAg positive mothers at the University Women's Hospital in Basel, Switzerland, in 2001 were identified and post-exposure immunisations were analysed. In addition, detailed written information on subsequent hepatitis B immunisations was obtained from the infants' paediatricians. A total of 1513 women gave birth to 1554 children and screening for HBsAg had been performed in 1503 (99%) women, of whom 8% were screened during delivery. A group of 18 (1.2%) women were HBsAg positive and 17 (95%) of the 19 exposed infants promptly received active and passive immunisation. One exposed infant was lost to follow-up and in one, postnatal vaccination was missed. Of the remaining 17 exposed infants, 9 (53%) received the full course of three active immunisations, but only two (12%) were immunised within the recommended time frame. On follow-up, six children were still too young for serological testing for successful immunisation. Among the remaining 11 immunised infants, serological testing had been performed in 4 (36%).
Compliance with recommendations for hepatitis B surface antigen screening was excellent in this study. The proportion of exposed infants receiving all three active immunisations was satisfactory, but more attention must be paid to complete and timely administration and serological testing in the future. This will require improved communication between neonatology units and care-providing paediatricians in private practices.
本研究的目的是确定是否符合预防围产期乙型肝炎病毒从乙型肝炎表面抗原（HBsAg）阳性母亲传播给其后代的官方建议。对2001年在瑞士巴塞尔大学妇女医院出生的所有HBsAg阳性母亲所生婴儿进行了识别，并对暴露后免疫接种情况进行了分析。此外，还从婴儿的儿科医生那里获得了关于后续乙型肝炎免疫接种的详细书面信息。共有1513名妇女分娩了1554名儿童，对1503名（99%）妇女进行了HBsAg筛查，其中8%是在分娩时进行筛查的。18名（1.2%）妇女HBsAg呈阳性，19名暴露婴儿中的17名（95%）立即接受了主动和被动免疫。1名暴露婴儿失访，1名婴儿错过产后疫苗接种。在其余17名暴露婴儿中，9名（53%）接受了全部三针主动免疫，但只有2名（12%）在推荐时间内接种。随访时，6名儿童因年龄太小无法进行血清学检测以确定免疫是否成功。在其余11名已接种疫苗的婴儿中，4名（36%）进行了血清学检测。
本研究中对乙型肝炎表面抗原筛查建议的依从性极佳。接受全部三针主动免疫的暴露婴儿比例令人满意，但未来必须更加关注免疫接种的完整和及时实施以及血清学检测。这将需要新生儿科与私人诊所提供护理的儿科医生之间加强沟通。
