Washington University School of Medicine, St. Louis, MO, United States.
University of California San Francisco, San Francisco, CA, United States.
Ann Hepatol. 2020 Jul-Aug;19(4):388-395. doi: 10.1016/j.aohep.2020.04.006. Epub 2020 May 20.
Universal vaccination at birth and in infancy is key to the elimination of chronic hepatitis B infection. We aimed to assess hepatitis B immune-prophylaxis and perinatal transmission knowledge, in a large and ethnically diverse cohort of previously pregnant North American women, chronically infected with hepatitis B.
The Hepatitis B Research Network (HBRN) is comprised of 28 Clinical Centers in the United States and Canada. Female cohort participants were administered a questionnaire to assess: (1) their assertion of knowledge regarding HBV prophylaxis at birth, testing, and diagnosis of hepatitis B in their children, and (2) the percentage of affirmative to negative responses for each of the HBV-related interventions her child may have received. The relationship between asserted knowledge, actions taken and maternal demographics were assessed.
A total of 351 mothers with 627 children born in or after 1992 were included. Median age at enrollment was 39.8 years. Mothers were mostly foreign-born with the largest percentage from Asia (73.4%) and Africa (11.7%). Of the 627 children, 94.5% had mothers who asserted that they knew whether their child had received HBIG or HBV vaccine at birth, for 88.8% of the children, their mothers indicated that they knew if their child was tested for HBV and for 84.5% of children, their mothers knew if the child was diagnosed with HBV infection. Among children whose mothers asserted knowledge of their HBV management, 95.3% were reported to have received HBIG or HBV vaccine, 83.4% of children were said to have been tested for HBV, and 4.8% of children were said to have been diagnosed with HBV. Younger maternal age was the only factor significantly associated with higher percentage of children for whom mothers reported knowledge of testing (p=0.02) or diagnosis of HBV (p=0.02).
While high percentages of North American children had mothers asserting knowledge of HBV prophylaxis and testing, knowledge gaps remain, with mothers of 5.5-15.5% of children lacking knowledge of key components of the HBV prevention and diagnosis in the perinatal setting. Targeted education of HBsAg-positive mothers may aid in closing this gap and reducing vertical transmission.
在婴儿出生时和婴儿期进行普遍疫苗接种是消除慢性乙型肝炎感染的关键。我们旨在评估乙型肝炎免疫预防和围产期传播知识，这是在一个由美国和加拿大的 28 个临床中心组成的大型、种族多样化的慢性乙型肝炎感染的北美孕妇队列中进行的。
乙型肝炎研究网络（HBRN）由美国和加拿大的 28 个临床中心组成。对女性队列参与者进行了问卷调查，以评估：（1）她们对婴儿出生时、乙型肝炎检测和诊断的乙型肝炎预防措施的知识主张；（2）其孩子可能接受的每一项乙型肝炎相关干预措施的肯定和否定回答的百分比。评估了主张知识、所采取的行动与产妇人口统计学之间的关系。
共纳入 351 名在 1992 年或之后分娩的母亲及其 627 名子女。入组时的中位年龄为 39.8 岁。母亲大多是外国出生的，其中最大比例来自亚洲（73.4%）和非洲（11.7%）。在 627 名儿童中，94.5%的母亲表示她们知道自己的孩子是否在出生时接种了乙肝免疫球蛋白或乙型肝炎疫苗，88.8%的母亲表示她们知道孩子是否接受了乙型肝炎病毒检测，84.5%的母亲表示她们知道孩子是否被诊断为乙型肝炎病毒感染。在母亲声称了解其乙型肝炎管理的儿童中，95.3%的儿童报告接受了乙肝免疫球蛋白或乙型肝炎疫苗接种，83.4%的儿童接受了乙型肝炎病毒检测，4.8%的儿童被诊断为乙型肝炎病毒感染。母亲年龄越小，与母亲报告的检测（p=0.02）或乙型肝炎诊断（p=0.02）的儿童比例越高相关。
尽管北美儿童中有很高比例的母亲表示了解乙型肝炎预防和检测知识，但仍存在知识差距，有 5.5-15.5%的儿童的母亲缺乏围产期乙型肝炎预防和诊断的关键知识。对乙型肝炎表面抗原阳性母亲进行有针对性的教育可能有助于缩小这一差距并减少垂直传播。
