对 HBsAg 阳性孕妇及其婴儿采取预防母婴传播措施的调查。
Survey of HBsAg-positive pregnant women and their infants regarding measures to prevent maternal-infantile transmission.
机构信息
The Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 430030, China.
出版信息
BMC Infect Dis. 2010 Feb 15;10:26. doi: 10.1186/1471-2334-10-26.
BACKGROUND
Intrauterine infection is the main contributor to maternal-infantile transmission of HBV. This is a retrospective study of 158 HBsAg-positive pregnant women who delivered children from Jan 1st, 2004 to Dec.31th, 2006 in Wuhan City, China. We investigated the measures taken to prevent maternal-infantile transmission of hepatitis B virus and the infection status of children.
METHODS
HBsAg-positive pregnant women were selected by a random sampling method when they accepted prenatal care in district-level Maternal and Child Health Hospitals. On a voluntary basis, these women completed questionnaires by face-to-face or phone interviews. The collected data were used to evaluate the immunization programs that pregnant women had received for preventing hepatitis B maternal-infantile transmission.
RESULTS
Among the 158 women, 143(90.5%) received Hepatitis B immune globulin during pregnancy, and 86.0% of their children were given Hepatitis B immune globulin and Hepatitis B vaccine. The rate of cesarean section was 82.3%, and 28.5% of these were aimed at preventing HBV infection. The rate of bottle feeding was 51.9%, and 89.0% of bottle feeding cases were for the purpose of preventing HBV infection. There were 71 cases of participants who were HBeAg-positive. Compared with the HBsAg+ HBeAg- group (only HBsAg-positive), the HBsAg + HBeAg+ group (HBsAg-positive and HBeAg-positive) had significantly higher rates of the caesarean section and bottle feeding resulting from hepatitis B (P < 0.05). Five cases were HBsAg-positive by Umbilical Cord Blood detection. The intrauterine infection rate of newborns was 6.7%. The chronic HBV rate of children was 4.0%.
CONCLUSION
Most HBsAg positive pregnant women have a growing awareness of maternal-infantile transmission of Hepatitis B virus and are receiving some form of preventative treatment, like combined immunization. Caesarean and bottle feeding are very common, often primarily to prevent transmission. Relatively few intrauterine infections were identified in this sample, but many infants did not appear to seroconvert after vaccination.
背景
宫内感染是母婴乙型肝炎病毒传播的主要原因。本研究是对 2004 年 1 月 1 日至 2006 年 12 月 31 日期间在武汉市分娩的 158 例乙型肝炎表面抗原（HBsAg）阳性孕妇的回顾性研究。我们调查了预防乙型肝炎母婴传播的措施和儿童的感染情况。
方法
采用随机抽样法在区县级妇幼保健院产检的 HBsAg 阳性孕妇中选择研究对象。孕妇自愿通过面对面或电话访谈完成问卷。收集的数据用于评估孕妇接受的乙型肝炎母婴传播免疫预防计划。
结果
在 158 例孕妇中，143 例（90.5%）在孕期接受了乙型肝炎免疫球蛋白，86.0%的儿童接受了乙型肝炎免疫球蛋白和乙型肝炎疫苗。剖宫产率为 82.3%，其中 28.5%的剖宫产是为了预防乙型肝炎病毒感染。奶瓶喂养率为 51.9%，89.0%的奶瓶喂养是为了预防乙型肝炎病毒感染。158 例孕妇中有 71 例 HBeAg 阳性。与 HBsAg+ HBeAg-组（仅 HBsAg 阳性）相比，HBsAg + HBeAg+组（HBsAg 阳性和 HBeAg 阳性）因乙型肝炎行剖宫产和奶瓶喂养的比例明显更高（P<0.05）。脐血检测发现 5 例 HBsAg 阳性。新生儿宫内感染率为 6.7%。儿童慢性乙型肝炎病毒感染率为 4.0%。
结论
大多数 HBsAg 阳性孕妇对乙型肝炎母婴传播的认识不断提高，并接受了某种形式的预防治疗，如联合免疫。剖宫产和奶瓶喂养非常普遍，通常主要是为了预防传播。在本研究样本中，宫内感染的比例相对较低，但许多婴儿在接种疫苗后似乎没有出现血清转换。
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