乙肝孕妇分娩方式与新生儿HBV宫内感染关系  

HBV intrauterine infection and delivery pattern in neonates with HBsAg positive mothers

作　　者：张玥[1] 魏俊妮[1] 郭珍[1] 冯丽萍[2] 汪波[2] 王素萍[1] 

机构地区：[1]山西医科大学公共卫生学院流行病学教研室,山西太原030001 [2]山西省太原市第三人民医院妇产科

出　　处：《中国公共卫生》2011年第10期1221-1222,共2页Chinese Journal of Public Health

基　　金：国家自然科学基金(30901227;30671794);山西省基础研究项目青年科技研究基金(2011021038-3)

摘　　要：目的探讨乙型肝炎孕妇分娩方式与新生儿乙型肝炎病毒（HBV）宫内感染的关系。方法采用问卷调查方式收集HBsAg阳性孕妇分娩方式等资料,用酶联免疫吸附试验检测孕妇和新生儿出生24 h内外周血乙肝病毒标志物,实时荧光定量PCR检测母亲和新生儿外周血HBV DNA含量。结果新生儿HBsAg阳性者101例,HBV DNA阳性者30例,二者任一项阳性者113例,宫内感染率为9.5%（113/1 191）;孕妇分娩时选择阴道产582例,剖宫产609例,2组宫内感染率差异有统计学意义（2χ=18.563,P=0.001）;孕妇血清HBeAg和HBV DNA均阴性、HBeAg阳性而HBV DNA阴性、HBeAg和HBV DNA均阳性时,阴道分娩组和剖宫产组新生儿宫内感染率差异均有统计学意义（2χ值分别为7.382、4.919、5.364,均P〈0.05）;HBsAg阳性孕妇HBV DNA含量≤103和105~107cop ies/mL时的分娩方式与宫内感染均有关（χ2值分别为10.777、8.450,均P〈0.05）。结论分娩方式与新生儿HBV宫内感染有关,HBsAg阳性孕妇选择剖宫产可能有利于降低HBV宫内感染率。Objective To explore the relationship between HBV intrauterine infection and delivery pattern in 1 191 neonates with HBsAg positive mothers.Methods The information on delivery pattern in HBsAg positive mothers were collected with a questionnaire survey.The hepatitis B virus（HBV） markers of the pregnant women and the neonates within 24 hours after the birth were detected with enzyme-linked immunosorbant assay（ELISA）.HBV DNA contents of pregnant women and the neonates were detected with real-time fluorescent quantitative（RT）-PCR.Results There were 101 HBsAg-positive and 30 HBV DNA-positive neonates in 1 191 neonates.The rate of HBV intrauterine infection was 9.5%.There was a significant difference in the rate of intrauterine infection between the women with vaginal delivery（582） and with cesarean section（609）（χ2=18.563,P=0.001）.There were significant differences in the intrauterine infection rates between viginal delivery and cesarean section for the women of HBeAg-negative and HBV DNA-negative,HBeAg-positive and HBV DNA-negative,and HBeAg-positeve and HBV DNA-positive.（χ2=7.382,4.919,5.364,P0.05 for all）.Among the HBsAg-positive women with HBV DNA level ≤103copies/ml or 105-107copies/ml,there was a correlation between delivery pattern and intrauterine infection（χ2=10.777,8.450,P0.05 for all）.Conclusion The delivery pattern has a significant effect on HBV intrauterine infection of the neonates with HBeAg positive mothers and the intrauterine infection rate could be reduced by cesarean section.

关 键 词：乙型肝炎 分娩方式 乙肝病毒 宫内感染 

分 类 号：R512.62[医药卫生—内科学]