乙型肝炎表面抗原阳性母亲新生儿乙型肝炎病毒宫内传播影响因素研究  

Factors influencing on HBV intrauterine transmission in neonates born to HBsAg-positive mothers

作　　者：丰淑英 李俊萍 高怡[3] 郭珍[3] 郭健[3] 张临瑞[3] 王婷[3] 王素萍[3] 

机构地区：[1]太原市第三人民医院妇产科,030001 [2]山西省第二人民医院妇产科 [3]山西医科大学流行病学教研室

出　　处：《中国药物与临床》2014年第4期413-415,共3页Chinese Remedies & Clinics

基　　金：国家自然科学基金(81072341);山西省留学人员科研资助项目(2008-50);山西省研究生优秀创新项目(20123065)

摘　　要：目的 探讨乙型肝炎表面抗原（HBsAg）阳性母亲新生儿发生乙型肝炎病毒（HBV）宫内传播的影响因素.方法 收集2011年7月至2013年7月在太原市第三人民医院妇产科分娩的HBsAg阳性孕妇及其新生儿396例.以是否发生HBV宫内传播将新生儿分为宫内传播组和非宫内传播组,分析母亲年龄、孕期HBV血清标志物水平、分娩方式、新生儿性别与新生儿HBV宫内传播的关系.统计分析采用x2检验、趋势x2检验和非条件Logistic回归模型.结果 单因素分析显示,母亲孕期乙型肝炎e抗原（HBeAg）阳性、HBV DNA阳性、HBeAg/HBV DNA双阳性和经剖宫产分娩与新生儿HBV宫内传播的发生有关（P＜0.05）;母亲年龄、新生儿性别与宫内传播的发生无关（P＞0.05）.多因素分析显示,HBeAg/HBV DNA双阳性（OR =3.662,95％CI为1.929～6.951）、经剖宫产分娩（OR=0.184,95％CI为0.090～0.375）被引入回归方程.趋势x2分析后显示,HBV DNA≥1＆#215;107 copies/ml时新生儿HBV宫内传播发生率明显上升.结论 经剖宫产分娩是HBsAg阳性母亲新生儿HBV宫内传播的保护因素,而母亲孕期血清HBeAg/HBV DNA双阳性和HBV DNA≥1＆#215;107 copies/ml时,新生儿HBV宫内传播发生的可能性较大.Objective To study the influencing factors of HBV intrauterine transmission in neonates born to HBsAg-positive mothers. Methods We recruited 396 HBsAg-positive mothers and their neonates from the Third People＇s Hospital of Taiyuan between July 2011 and July 2013. The neonates were assigned to HBV intrauterine transmission group and non-intrauterine transmission group. This entailed assessment of the age of mothers, serum HBV-associated biomarkers during pregnancy, the method of delivery and the relation between neonate＇s gender and neonatal HBV intrauterine transmission. The statistical analyses comprised chi-square, trend for chi-square test and non-conditional Logistic regression analysis. Results Univariate analyses indicated that neonates born to HBeAg- positive mothers, HBV-DNA positive, HBeAg and HBV-DNA positive and cesarean delivery, but not mother＇s age or neonate＇s gender, were associated with HBV intrauterine transmission （all P〈0.05）. Multivariate analysis showed that HBeAg/HBV DNA positive （OR=3.662, 95%CI： 1.929-6.951） and cesarean delivery （OR=0.184, 95%CI： 0.090- 0.375） were associated with HBV intrauterine transmission. It was shown by analysis of trend chi-square test that there was a trend towards increased rate of neonatal HBV intrauterine transmission in mothers with HBV DNA load of 1 ×10^7 copies/ml or greater. Conclusion Cesarean delivery is a protective factor for HBV intrauterine transmission. Ma- ternal HBeAg/HBV DNA positive and HBV-DNA load of 1 ×10^7 copies/ml or greater suggests a higher likelihood of HBV intrauterine transmission.

关 键 词：肝炎病毒 乙型 肝炎表面抗原 乙型 宫内传播 新生儿 

分 类 号：R512.62[医药卫生—内科学]