Zhou Qiongjie, Li Xiaotian, Wang Qiaomei, Shen Haiping, Zhang Yiping, Zhang Shikun, Acharya Ganesh
Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China.
Paediatr Perinat Epidemiol. 2017 Jun 15. doi: 10.1111/ppe.12371.
Hepatitis B virus (HBV) infection during pregnancy is associated with perinatal complications and poor maternal and fetal outcomes. There is a lack of reports on HBV infection screening, prophylaxis, and/or treatment in preconception period among women planning a pregnancy. This study is to investigate the prevalence and demographic characteristics of HBV infection among rural women of reproductive age planning pregnancy within 6 months, in different geographical regions of China.
A population-based, cross-sectional, sero-survey of HBV infection among women intending to get pregnant within 6 months was carried out as a part of the National Free Preconception Health Examination Project covering 31 provinces in mainland China between 2010-12. General information (age, residence status, race, education, and occupation), HBV infection and vaccination history was collected. Results of HBV serological test panel were recorded for analysis.
Of 2 120 131 women, 2 028 361 (95.7%) samples of HBV serology were available for analysis. Participating women were of young age (median 28.1 years), mostly engaged in agricultural activities (78.1%), and had high school education or lower (89.6%). The overall prevalence of HBsAg sero-positivity was 4.9%, which corresponds to an intermediate epidemic, with a wide geographical variation that ranged from 1.1% in Shanxi to 13.0% in Tibet. 90.1% women were susceptible to HBV with a 24.5% self-reported HBV vaccination rate.
Significant regional differences in HBV prevalence, and a vast majority of women of childbearing age being susceptible to HBV, calls for a targeted HBV screening and vaccination strategy for women and their offspring in rural China.
孕期感染乙型肝炎病毒（HBV）与围产期并发症以及母婴不良结局相关。对于计划怀孕的女性，孕前HBV感染筛查、预防和/或治疗方面的报道较少。本研究旨在调查中国不同地理区域内计划在6个月内怀孕的农村育龄妇女中HBV感染的患病率及人口统计学特征。
作为国家免费孕前健康检查项目的一部分，于2010年至2012年在中国大陆31个省份开展了一项基于人群的横断面血清学调查，对象为计划在6个月内怀孕的女性。收集了一般信息（年龄、居住状况、种族、教育程度和职业）、HBV感染及疫苗接种史。记录HBV血清学检测结果用于分析。
在2120131名女性中，有2028361份（95.7%）HBV血清学样本可供分析。参与研究的女性年龄较轻（中位数为28.1岁），大多从事农业活动（78.1%），高中及以下学历者占89.6%。HBsAg血清阳性的总体患病率为4.9%，属于中等流行水平，地理差异较大，从山西的1.1%到西藏的13.0%不等。90.1%的女性对HBV易感，自我报告的HBV疫苗接种率为24.5%。
HBV患病率存在显著的地区差异，且绝大多数育龄妇女对HBV易感，这就需要为中国农村妇女及其后代制定有针对性的HBV筛查和疫苗接种策略。
