Kumar M L, Dawson N V, McCullough A J, Radivoyevitch M, King K C, Hertz R, Kiefer H, Hampson M, Cassidy R, Tavill A S
Ann Intern Med. 1987 Sep;107(3):273-7. doi: 10.7326/0003-4819-107-2-273.
To assess the sensitivity of historical risk factors for identification for hepatitis B surface antigen (HBsAg)-positive parturients, 4399 pregnant women were consecutively screened for HBsAg. Information regarding risk for hepatitis B infection was obtained from each HBsAg-positive parturient. Twenty-three HBsAg-positive subjects were identified (5.2/1000 deliveries). The HBsAg carrier rate (18/2231, or 8.1/1000 deliveries) was significantly higher in women of black, Asian, or Hispanic origin than in the remaining ethnic groups (non-Hispanic whites plus all others, 5/2168, or 2.3/1000 deliveries) (chi square, 5.95; p = 0.016). Risk factors for identification of HBsAg-positive women were present in 10 of 22 asymptomatic subjects (sensitivity, 45%; 95% confidence interval, 24% to 68%). Much of the information required to assess one of these risk factors, previous infection, involved detailed questioning and is unlikely to be obtained in the context of conventional obstetrical care. Routine maternal HBsAg screening programs may be needed if transmission of hepatitis B from mother to infant is to be prevented.
为评估乙肝表面抗原（HBsAg）阳性产妇的历史风险因素识别的敏感性，对4399名孕妇连续进行了HBsAg筛查。从每位HBsAg阳性产妇处获取了有关乙肝感染风险的信息。共识别出23名HBsAg阳性受试者（5.2/1000次分娩）。黑人、亚洲或西班牙裔女性的HBsAg携带率（18/2231，即8.1/1000次分娩）显著高于其他种族群体（非西班牙裔白人加所有其他种族，5/2168，即2.3/1000次分娩）（卡方检验，5.95；p = 0.016）。22名无症状受试者中有10名存在识别HBsAg阳性女性的风险因素（敏感性，45%；95%置信区间，24%至68%）。评估其中一个风险因素（既往感染）所需的许多信息涉及详细询问，不太可能在常规产科护理中获得。如果要预防乙肝从母亲传播给婴儿，可能需要开展常规的孕产妇HBsAg筛查项目。
