孕妇乙型肝炎病毒携带对其新生儿围产期结局及远期生长的影响  

Effect of maternal hepatitis B virus carrier status on perinatal outcome and long-term growth of the neonates

作　　者：徐飚[1] 刘兰华[1] 陈洁[2] 张姝[2] 周乙华[2] 胡娅莉[2] 

机构地区：[1]江苏省泰兴市人民医院妇产科,225400 [2]南京大学医学院附属鼓楼医院

出　　处：《中国妇幼保健》2014年第24期3953-3955,共3页Maternal and Child Health Care of China

基　　金：国家临床重点专科建设项目〔2011271〕;江苏省母胎医学重点学科建设项目〔XK201102〕

摘　　要：目的：探讨母亲孕期乙肝表面抗原（HBsAg）携带对妊娠结局和其子女远期生长的影响。方法：回顾性分析2002—2004年江苏地区380例HBsAg阳性和428例HBsAg阴性单胎妊娠孕妇的新生儿结局；比较两组新生儿出生体重和身长，以及早产、死胎／死产等不良妊娠结局。并于2009年10月-2010年3月随访这些儿童，检查其生长发育情况。结果：HBsAg阳性孕妇分娩的新生儿出生体重和身长分别为（3436．1±388．1）g和（49．8±2．4）cm，与HBsAg阴性孕妇分娩的新生儿比较[（34．66±435．2）g和（49．9±2．4）cm]，差异无统计学意义（JP均〉0．05）。HBsAg阳性组早产率（2．9％）略高于阴性组（1．4％），但差异无统计学意义（P=0．140）。两组死胎或死产（0．5％vs.0．2％）、新生儿死亡（0．5％郴．0．5％）和先天性畸形（0．8％vs．1．4％）的发生率相近。Logistic回归证实母孕期HBsAg携带与不良妊娠结局无关（P均〉0．05）。随访时，271例（71．3％）HBsAg阳性孕妇分娩的儿童与297例（69．4％）HBsAg阴性孕妇所分娩的儿童的体重和身高比较，差异均无统计学差异（P〉0．05）。HBsAg阳性孕妇分娩的儿童出现1例（0．26％）脑瘫，而HBsAg阴性孕妇分娩的儿童出现4例（0．93％）异常。结论：母亲孕期HBsAg携带不增加不良妊娠结局风险，且不影响其子女远期生长。产前检查时无须特别对HBsAg阳性孕妇进行不良妊娠结局风险评估。Objective： To explore the effect of maternal HBsAg carrier status on perinatal outcome and long - term growth of the neonates. Methods： The outcomes of neonates born by 380 pregnant women with positive HBsAg and 428 pregnant women with negative HBsAg of single pregnancy in Jiangsu area from 2002 to 2004 were analyzed retrospectively; neonatal birth weights and heights and adverse pregnancy outcomes （ such as premature delivery, stillbirth） in the two groups were compared ; these children were followed up from October 2009 to March 2010 to examine their growth and development conditions. Results： The birth weight and height of neonates born by HBsAgpositive mothers were （3 436. 1 v 388.1 ） g and （49. 8±2.4） cm, respectively, compared with the neonates born by HBsAg - negative women, there was no statistically significant difference （ P 〉 0.05 ） . The incidence rate of premature delivery in HBsAg - positive group was slightly higher than that in HBsAg- negative group, but there was no statistically significant difference （P = 0. 140） . There was no statistically significant difference in the incidence rates of stillbirth （0. 5% vs. 0. 2% ）, neonatal death （0. 5% vs. 0. 5% ） and congenital malformations （0. 8% vs. 1.4% ） . Logistic regression analysis demonstrated that maternal HBsAg carrier status was not correlated with adverse pregnancy outcome （ P 〉 0.05 ） . During follow - up, there was no statistically significant difference in body weight and body height between 271 children （71.3%） born by HBsAgpositive mothers and 297 children （69.4%） born by HBsAgnegative mothers （P 〉 0. 05 ） . Among the children born by HBsAg -positive mothers, one child （0. 26% ） was found with cerebral palsy, while among the children born by HBsAg - negative mothers, four children （0. 93% ） were found with abnormalities. Conclusion： Maternal HBsAg carrier status does not raise risk for adverse neonatal outcome and does not affect long - term growth of their children.

关 键 词：乙型肝炎病毒 孕妇 新生儿结局 儿童生长 

分 类 号：R512.62[医药卫生—内科学]