Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.
BMC Infect Dis. 2024 Sep 11;24(1):957. doi: 10.1186/s12879-024-09848-2.
This study aims to analyze whether undergoing amniocentesis during pregnancy in women diagnosed with hepatitis B virus (HBV) infection leads to HBV transmission to newborns.
Retrospective data collection was conducted from June 2019 to November 2022 on expectant mothers positive for hepatitis B surface antigen (HBsAg) who underwent amniocentesis at The Third Affiliated Hospital of Sun Yat-sen University, along with data on their newborns. The study summarized the HBV infection status of newborns born to mothers with different expressions of hepatitis B e antigen (HBeAg), antiviral treatment versus no treatment, and different HBV DNA viral loads before delivery.
In this study, 346 expectant mothers tested positive for HBsAg, along with 351 newborns (including 5 sets of twins, with 8 infants (2.28%) testing HBsAg-positive at birth. All newborns received dual immunotherapy and were followed up. At 7-12 months, retesting for HBsAg positivity and HBV DNA positivity among infants revealed that out of the infants born with HBsAg positivity, 7 cases had seroconverted to negative, while the remaining infant, who was positive for both HBsAg and HBeAg at birth, tested positive for both HBsAg and HBV DNA at 7-12 months. Thus, one case of vertical transmission of hepatitis B from mother to child occurred in this study. The proportion of infants born with HBsAg + among newborns born to HBeAg-positive mothers (4 cases, 6.06%) was significantly higher than that among newborns born to HBeAg-negative mothers (4 cases, 1.41%) (P < 0.05). The proportion of infants born with HBsAg + showed no significant difference between newborns born to mothers receiving antiviral therapy (2 cases, 2.90%) and those born to mothers not receiving antiviral therapy (6 cases, 2.13%) (P > 0.05). Among expectant mothers with viral load ≥ 6 log 10 IU/mL before delivery, 3 newborns (30.00%) were manifesting HBsAg positivity at birth, significantly higher than the group with viral load < 6 log 10 IU/mL before delivery (5 cases, 1.47%) (P < 0.05).
Among HBsAg-positive expectant mothers, only a small number of infants are infected with the hepatitis B virus at birth, the proportion of which is relatively low. Infants born to mothers who are HBeAg-positive or have a viral load ≥ 6 log10 IU/mL have a higher risk of being born positive.
本研究旨在分析乙型肝炎病毒（HBV）感染孕妇行羊膜穿刺术是否会导致 HBV 传播给新生儿。
回顾性收集 2019 年 6 月至 2022 年 11 月在中山大学附属第三医院行羊膜穿刺术的 HBsAg 阳性的孕妇及其新生儿的临床资料。总结不同 HBeAg 表达、抗病毒治疗与未治疗、分娩前 HBV DNA 病毒载量不同的母亲所生新生儿的 HBV 感染状况。
本研究中，346 例 HBsAg 阳性的孕妇共分娩 351 例新生儿（包括 5 对双胞胎，8 例新生儿（2.28%）出生时 HBsAg 阳性。所有新生儿均接受双重免疫治疗并进行随访。7-12 个月时，对 HBsAg 阳性和 HBV DNA 阳性的婴儿进行复查，结果显示，在出生时 HBsAg 阳性的婴儿中，7 例转为阴性，而另 1 例出生时 HBsAg 和 HBeAg 均阳性的婴儿，在 7-12 个月时 HBsAg 和 HBV DNA 均阳性。因此，本研究中有 1 例乙型肝炎母婴垂直传播。HBeAg 阳性母亲所生新生儿中 HBsAg+的比例（4 例，6.06%）明显高于 HBeAg 阴性母亲所生新生儿（4 例，1.41%）（P<0.05）。抗病毒治疗母亲所生新生儿中 HBsAg+的比例（2 例，2.90%）与未抗病毒治疗母亲所生新生儿（6 例，2.13%）差异无统计学意义（P>0.05）。分娩前病毒载量≥6 log 10 IU/mL 的孕妇中，有 3 例（30.00%）新生儿出生时 HBsAg 阳性，明显高于病毒载量<6 log 10 IU/mL 的孕妇（5 例，1.47%）（P<0.05）。
在 HBsAg 阳性的孕妇中，仅有少数婴儿在出生时感染乙型肝炎病毒，其比例相对较低。HBeAg 阳性或病毒载量≥6 log10 IU/mL 的母亲所生婴儿感染乙型肝炎病毒的风险更高。
