Kuller J A, Meyer M P, Leonhard K R, Harger J H
Department of Obstetrics and Gynecology, University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pennsylvania 15213.
J Perinatol. 1991 Jun;11(2):164-7.
We sought to determine whether the recent Centers for Disease Control recommendation of universal prenatal screening for hepatitis B surface antigen (HBsAg) is necessary or cost-effective in a population of private patients. During the 21 months of our study there were 17,973 deliveries at Magee-Womens Hospital, the largest-volume private obstetrics service in the United States. We screened 12,377 of these patients for HBsAg. Only 11 patients, 0.09% of those screened (5 private and 6 clinic) tested positive. We administered questionnaires regarding historical risk factors for hepatitis B to all 11 patients testing positive for HBsAg and to 100 controls who tested negative for HBsAg. All private patients and 5 of 6 clinic patients testing positive for HBsAg had identifiable risk factors for hepatitis B. In addition, historical risk factors for hepatitis B were identified in 29% of the women testing negative for HBsAg. We found historical risk factors to be excellent predictors of the presence of HBsAg in our private patients. Our data indicate that universal screening for HBsAg is not necessary in private patients.
我们试图确定疾病控制中心最近建议的对所有孕妇进行乙肝表面抗原（HBsAg）普遍筛查，在私立医院患者群体中是否必要或具有成本效益。在我们研究的21个月期间，美国最大规模的私立产科服务机构麦吉妇女医院有17973例分娩。我们对其中12377例患者进行了HBsAg筛查。只有11例患者（占筛查患者的0.09%，其中5例为私立医院患者，6例为诊所患者）检测呈阳性。我们向所有11例HBsAg检测呈阳性的患者以及100例HBsAg检测呈阴性的对照者发放了关于乙肝历史风险因素的问卷。所有检测呈阳性的私立医院患者以及6例诊所患者中的5例都有可识别的乙肝风险因素。此外，在HBsAg检测呈阴性的女性中，29%的人有乙肝历史风险因素。我们发现历史风险因素是我们私立医院患者中HBsAg存在情况的极佳预测指标。我们的数据表明，对私立医院患者进行HBsAg普遍筛查没有必要。
