妊娠合并隐匿性或显性乙型肝炎病毒(HBV)感染对早产发生率的影响  

The impact of occult or overt hepatitis B virus(HBV)infection during pregnancy on the incidence of preterm birth

作　　者：卜一畅 刘海燕[2] 孔德川[1] 熊海燕[3] 汪艳[4] 胡安群[2] 赵耐青[5] 陆一涵[1] 郑英杰[1,3] 

机构地区：[1]复旦大学公共卫生学院流行病学教研室-教育部公共卫生重点实验室,上海200032 [2]安徽省安庆市立医院检验科,安庆246003 [3]复旦大学公共卫生学院卫生微生物学教研室,上海200032 [4]安徽省安庆市立医院妇产科,安庆246003 [5]复旦大学公共卫生学院卫生统计学教研室,上海200032

出　　处：《复旦学报（医学版）》2014年第6期779-783,共5页Fudan University Journal of Medical Sciences

基　　金：国家自然科学基金面上项目(81373065);上海市教育委员会科研创新重点项目(14ZZ015);上海市公共卫生重点学科建设项目(12GWZX0101)~~

摘　　要：目的探讨妊娠合并隐匿性或显性乙型肝炎病毒(hepatitis B virus,HBV)感染对早产发生率的影响。方法采用前瞻性队列研究设计,以2012年6月1日至2013年3月15日间安庆市立医院所有住院分娩的孕妇为研究对象,纳入妊娠结局为单胎活产的孕妇,收集其血清并进行HBV表面抗原和HBV S基因片段的检测,并通过医院电子病历系统收集孕妇人口学信息等资料,采用单因素和多因素统计方法分析妊娠合并隐匿性和显性HBV感染对早产发生率的影响。结果孕妇早产发生率为21.00%(189/900);其中隐匿性HBV感染组、显性HBV感染组和非HBV感染组孕妇在人口学特征方面相似可比,其早产发生率分别为20.51%(16/78)、20.00%(14/70)、21.14%(159/752)。单因素与多因素分析未发现早产发生率与HBV感染相关,以非HBV感染组为参照,多因素COX回归分析发现显性HBV感染、隐匿性HBV感染与早产间调整后相对危险度(adjusted risk ratio,RRa)分别为1.03(0.81,1.32)和0.99(0.78,1.25);以同样参照,多因素线性回归分析发现孕周与HBV感染状况的回归系数β为0.09(-0.14,0.31)。结论妊娠合并隐匿性或显性HBV感染与早产的发生率无明显相关。Objective To examine the impact of occult or overt hepatitis B virus（HBV） infection during pregnancy on the incidence of preterm birth. Methods We prospectively enrolled singleton pregnant women with alive newborns from June I st, 2012 to March I5, 2013 in Anqing City Hospital.Serum samples were collected and tested with HBV surface antigen and S gene segment. Demographic information was collected from hospital electronic medical records system. Then single variate and multivariate analysis were used to compare the incidence of preterm birth by the status of infection with HBV. Results The proportion of preterm birth rate was 2l.00%（189/900） overall and it was 20.51% （16/78） ,20.00% （14/70） and 21.14% （159/752） respectively among pregnant women with occult HBV infection （OBI）, those with overt HBV infection and those non-HBV controls, whose demographic characteristics were roughly comparable. The single and muhivariate analysis did not find that the incidence of preterm birth was significantly associated with the status of infection with HBV. Based on the Non-HBV group, the mutivariate analysis of COX regression found that the adjusted relative ratio （RRa） was 1.03 （0.81,1.32） for the overt HBV group while the RRa was 0.99 （tl. 78, 1.25） for the OBI group. The multiple linear regression showed that the regression coefficient was 0.09 （ - 0.14,0.31） of gestational weeks against HBV infection groups. Conclusions Our results show that infection with occult or overt HBV does not have an obvious correlation with prmerm birth.

关 键 词：隐匿性乙型肝炎病毒感染(OBI) 显性乙型肝炎病毒(HBv) 孕妇 早产 

分 类 号：R183.9[医药卫生—流行病学]