op de Coul Eline L M, van Weert J W M Yolanda, Oomen Petra J, Smit Colette, van der Ploeg C P B Kitty, Hahné Susan J M, Notermans Daan W, van der Sande Marianne A B
Rijksinstituut voor Volksgezondheid en Milieu (RIVM), Centrum Infectieziektebestrijding (CIb), Bilthoven, the Netherlands.
Ned Tijdschr Geneeskd. 2010;154:A2175.
Evaluation of the effectiveness of antenatal screening in the Netherlands for HIV, hepatitis B virus (HBV) and syphilis, in preventing mother-to-child transmission.
Descriptive.
The results of antenatal screening in the period 2006-2008 were compared with data from pregnant women and newborns from other data sources.
Each year, around 185,000 pregnant women were screened for HIV, HBV and syphilis. Refusal rates for the screening tests were low, and were highest (0.2%) for HIV. Prior to the introduction of screening, 5-10 children were born with HIV annually. After the introduction of screening in 2004, only 4 children were born with HIV (an average of 1 per year). Two of these mothers had become pregnant prior to 2004; the third mother was HIV negative at screening and probably became infected after screening; the fourth mother's background was unknown. Congenital syphilis was diagnosed in fewer than 5 newborns annually and 5 children were infected with HBV. In 3 of these the mothers were HBeAg positive (a marker for high infectivity). We estimated that 5-10 HIV, 50-75 HBV and 10 syphilis cases in newborns had been prevented annually as a result of screening.
The screening programme was effective in detecting HIV, HBV and syphilis in pregnant women and in preventing transmission to the child. Since the introduction of the HIV screening the number of children born with HIV has fallen dramatically.
评估荷兰产前筛查对预防人类免疫缺陷病毒(HIV)、乙型肝炎病毒(HBV)和梅毒母婴传播的有效性。
描述性研究。
将2006 - 2008年期间的产前筛查结果与来自其他数据源的孕妇和新生儿数据进行比较。
每年约有18.5万名孕妇接受HIV、HBV和梅毒筛查。筛查试验的拒绝率较低,其中HIV筛查的拒绝率最高(0.2%)。在引入筛查之前,每年有5 - 10名儿童出生时感染HIV。2004年引入筛查后,只有4名儿童出生时感染HIV(平均每年1名)。其中两名母亲在2004年之前怀孕;第三名母亲筛查时HIV阴性,可能在筛查后感染;第四名母亲的背景不明。每年诊断出先天性梅毒的新生儿少于5例,5名儿童感染HBV。其中3名母亲HBeAg阳性(高传染性标志物)。我们估计,由于筛查,每年可预防5 - 10例新生儿HIV感染、50 - 75例新生儿HBV感染和10例新生儿梅毒感染。
该筛查计划在检测孕妇中的HIV、HBV和梅毒以及预防母婴传播方面是有效的。自引入HIV筛查以来,出生时感染HIV的儿童数量大幅下降。