Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Kunming Medical University, Kunmin City, Yunnan, China.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China.
Ann Epidemiol. 2020 Sep;49:13-19. doi: 10.1016/j.annepidem.2020.05.011. Epub 2020 Jul 2.
China has the world's largest burden of hepatitis B virus (HBV) infection. However, there are few studies reported on the latest prevalence of hepatitis B surface antigen (HBsAg) among pregnant women in China. We aimed to assess the prevalence of HBV infection and its associated risk factors among pregnant women in Yunnan, which is a province with relatively high prevalence of blood-borne viruses.
We conducted a cross-sectional study of 15,641 pregnant women who underwent routine antenatal screening for HBsAg in Yunnan between 2013 and 2016. Logistic regression analyses were used to examine the associations between HBV infection and risk factors.
Overall, 7.89% (95% confidence interval (CI), 7.47%-8.31%) of the 15,641 pregnant women tested positive for HBsAg. Multivariable logistic regression analysis showed that advanced age (≥35 years old; adjusted odds ratio [aOR], 2.43-2.59), Hani ethnicity (aOR, 1.97; 95% CI, 1.22-3.17), unemployed women (aOR, 1.88; 95% CI, 1.30-2.72), multigravidas (aOR, 1.21; 95% CI, 1.05-1.40), and multiparas (aOR, 1.28; 95% CI, 1.10-1.49) were more likely to be infected with HBV. HBV infection was associated with cesarean section and preterm birth, with aORs of 1.31 (1.17-1.48) and 1.23 (1.00-1.51), respectively. In the subgroup analysis, the association between Hani ethnicity and HBV infection was significantly higher in women aged 35 years or older (aOR = 5.15; 95% CI, 1.51-17.55) than in women younger than 35 years of age (aOR = 1.69; 95% CI, 1.00-2.86).
HBV infection among 15,641 pregnant women was of high-intermediate endemicity in Yunnan, China. Advanced age, Hani ethnicity, unemployment, and multigravid and multiparous statuses were associated with an increased prevalence of HBV infection. High-risk pregnant women should be paid more attention during routine antenatal examination.
中国是乙型肝炎病毒(HBV)感染人数最多的国家。然而,目前关于中国孕妇乙型肝炎表面抗原(HBsAg)最新流行率的研究较少。本研究旨在评估云南省孕妇 HBV 感染的流行率及其相关危险因素,该省是血液传播病毒流行率较高的省份之一。
我们对 2013 年至 2016 年间在云南省接受常规产前 HBsAg 筛查的 15641 名孕妇进行了横断面研究。采用 logistic 回归分析 HBV 感染与危险因素之间的关系。
总体而言,15641 名孕妇中 HBsAg 阳性率为 7.89%(95%置信区间(CI):7.47%-8.31%)。多变量 logistic 回归分析显示,高龄(≥35 岁;调整优势比[aOR],2.43-2.59)、哈尼族(aOR,1.97;95%CI,1.22-3.17)、失业(aOR,1.88;95%CI,1.30-2.72)、多产妇(aOR,1.21;95%CI,1.05-1.40)和多产次(aOR,1.28;95%CI,1.10-1.49)的孕妇更易感染 HBV。HBV 感染与剖宫产和早产有关,OR 值分别为 1.31(1.17-1.48)和 1.23(1.00-1.51)。在亚组分析中,35 岁及以上的哈尼族孕妇与 HBV 感染的相关性明显高于 35 岁以下的哈尼族孕妇(aOR=5.15;95%CI,1.51-17.55)。
在云南省,15641 名孕妇的 HBV 感染率处于中高度流行水平。高龄、哈尼族、失业以及多产妇和多产次与 HBV 感染率升高有关。高危孕妇在常规产前检查中应给予更多关注。