From the Pediatric Gastroenterology Unit, Regina Margherita Children's Hospital, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy.
the Center of Excellence for the Development and Implementation of Medicines, Vaccines, and Medical Devices for Pediatric Use, INCiPiT Italian Network For Pediatric Clinical Trials, Bambino Gesù Children's Hospital IRCCS, Roma, Italy.
J Pediatr Gastroenterol Nutr. 2023 Jun 1;76(6):716-722. doi: 10.1097/MPG.0000000000003765. Epub 2023 Mar 16.
Prevention of vertical transmission of hepatitis B virus (HBV) infection is crucial to eliminate viral hepatitis as a major public health threat by 2030. We aimed to assess the current hospital policies and practices implemented before, at, and after birth, and to evaluate potential barriers to the full application of international guidelines.
A web-based survey was supported by PENTA Foundation and distributed across Europe from October to December 2021.
Overall, 76 centers with delivery departments completed the survey. Hepatitis B surface antigen (HBsAg) maternal screening is performed in the first trimester of pregnancy in 53% of the centers and in the third in 46%. HBsAg positive pregnant women are tested for serologic HBV markers and HBV-DNA in 78% and 63% of the departments; 38% of the HBeAg positive women with high HBV-DNA levels are treated during the last trimester of pregnancy. At birth, 91% of the departments administer HBV vaccine to infants born to HBsAg positive mothers within 12 hours of birth; 74% test women with unknown HBsAg status and 78% of them wait for the maternal testing results before administering HBV vaccine to their newborns. After birth, 47% of the departments provide postvaccination serological testing for infants born to HBsAg positive mothers. The timing of the HBV vaccine schedule varies greatly.
There is significant heterogeneity in the hospital policies and correlated procedures. The implementation of a multidisciplinary clinical pathway is a must if a stronger connection between the prenatal, perinatal, and postnatal phases is to be established.
预防乙型肝炎病毒（HBV）母婴垂直传播对于到 2030 年消除病毒性肝炎这一主要公共卫生威胁至关重要。本研究旨在评估目前在产前、产时和产后实施的医院政策和措施，并评估全面应用国际指南的潜在障碍。
2021 年 10 月至 12 月，PENTA 基金会支持了一项基于网络的调查，并在欧洲各地进行。
共有 76 个有分娩部门的中心完成了调查。53%的中心在妊娠早期进行乙肝表面抗原（HBsAg）的母体筛查，46%的中心在妊娠晚期进行筛查。78%和 63%的科室对 HBsAg 阳性的孕妇进行了血清学 HBV 标志物和 HBV-DNA 检测；38%的 HBeAg 阳性、HBV-DNA 水平较高的孕妇在妊娠晚期接受治疗。在分娩时，91%的科室在 HBsAg 阳性母亲所生婴儿出生后 12 小时内给予 HBV 疫苗；74%的科室检测 HBsAg 状态未知的母亲，78%的科室在为新生儿接种 HBV 疫苗前等待母亲的检测结果。产后，47%的科室对 HBsAg 阳性母亲所生婴儿进行了疫苗接种后的血清学检测。HBV 疫苗接种方案的时间安排差异很大。
医院政策和相关程序存在显著异质性。如果要加强产前、围产期和产后各阶段之间的联系，就必须实施多学科临床路径。
