Alrowaily Mohammed A, Abolfotouh Mostafa A, Ferwanah Mazen S
King Fahad National Guard Hospital, King Abdulaziz Medical City, NGHA, Riyadh, Saudi Arabia.
Saudi J Gastroenterol. 2008 Apr;14(2):70-2. doi: 10.4103/1319-3767.39621.
BACKGROUND/AIM: Since selective screening for Hepatitis B virus (HBV) in pregnant women has failed to identify a high proportion of HBV-infected mothers, pre-natal HBsAg testing of all pregnant women is now recommended. We aimed to determine the prevalence of HBV infection among pregnant women at the ante-natal clinic of a tertiary care center in Saudi Arabia and to identify the target group for postpartum immunization.
A total of 755 pregnant females who attended the antenatal clinic from June 2005 to June 2006 for the first time - before 38 weeks of gestation - constituted the target of the present study. Blood samples 30-39 were drawn from all subjects and sera were tested for HBV serologic markers including Hepatitis B surface antigen, anti-HBs, and anti-HBc using ELISA technique (third generation).
The overall prevalence of sero-positive HBsAg among pregnant women was 1.6%. As age increased, the prevalence of sero-positive HBsAg significantly increased (chi(2) = 116.43, P < 0.001), 30-39 were women aged >or=40 were five times more likely to be positive for HBsAg as compared to those <30 years (OR = 4.78). On the other hand, women aged 40 and over were five times more likely to be susceptible to infection with hepatitis as compared to young women aged <20 (OR = 5.15). Women susceptible to HBV infection constituted about 80% of all pregnant females.
These findings reflect that the full impact of the Hepatitis B vaccination program that was conducted in 1989 for all Saudi children has not yet reached all pregnant women, with the majority (79.9%) being nonimmune and thus liable to HBV infection. Postpartum HB immunization should be recommended in such cases.
背景/目的:由于对孕妇进行乙型肝炎病毒(HBV)的选择性筛查未能识别出高比例的HBV感染母亲,现在建议对所有孕妇进行产前HBsAg检测。我们旨在确定沙特阿拉伯一家三级医疗中心产前诊所孕妇中HBV感染的患病率,并确定产后免疫的目标人群。
2005年6月至2006年6月首次到产前诊所就诊(妊娠38周前)的755名孕妇构成了本研究的对象。从所有受试者采集30 - 39份血样,使用酶联免疫吸附测定技术(第三代)检测血清中的HBV血清学标志物,包括乙型肝炎表面抗原、抗-HBs和抗-HBc。
孕妇中HBsAg血清学阳性的总体患病率为1.6%。随着年龄的增加,HBsAg血清学阳性的患病率显著增加(χ² = 116.43,P < 0.001),年龄≥40岁的女性HBsAg阳性的可能性是<30岁女性的5倍(比值比 = 4.78)。另一方面,40岁及以上的女性感染肝炎的易感性是<20岁年轻女性的5倍(比值比 = 5.15)。易感染HBV的女性约占所有孕妇的80%。
这些发现表明,1989年针对所有沙特儿童实施的乙肝疫苗接种计划的全面影响尚未惠及所有孕妇,大多数(79.9%)孕妇无免疫力,因此易感染HBV。在这种情况下应建议进行产后乙肝免疫接种。