孕妇乙型肝炎病毒宫内感染相关危险因素研究  

Study on the risk factors for intrauterine infection of hepatitis B virus among pregnant women

作　　者：杨松静 黄桢翔 陈碧钦 施明明[2] 陈江慧 陈静[2] 刘惠芬[2] 苏艳华[2] 柯遐义[2] 赵本华[2] 

机构地区：[1]厦门市思明区妇幼保健院妇产科,福建厦门361000 [2]厦门大学公共卫生学院预防医学系,福建厦门361102 [3]厦门市思明区妇幼保健院医务科,福建厦门361000

出　　处：《中华疾病控制杂志》2017年第1期44-47,共4页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(81373086);厦门市科技计划项目(3502Z20144070)

摘　　要：目的探讨厦门市孕妇乙型肝炎病毒(hepatitis B virus,HBV)感染情况和HBV宫内感染的影响因素。方法在1 064名孕妇第一次到医院建立孕产妇保健卡时进行问卷调查并检测其血清乙肝标志物,根据检测结果选择外周血乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阳性的产妇179例随访至其分娩,并采集其分娩时的脐血和胎盘组织。对脐血进行HBsAg和HBV DNA的检测,对胎盘组织进行HBsAg的检测。采用χ2检验和非条件Logistic回归分析相关因素与HBV宫内感染的关系。结果被调查的1 064名孕妇中,HBsAg阳性的孕妇共179名,感染率为16.8%。对179名HBsAg阳性的孕妇的脐血进行检测发现,发生HBV宫内感染的孕妇共34名,感染率为19.0%。孕妇HBV宫内感染的危险因素为胎盘HBsAg阳性、孕妇血清乙型肝炎E抗原(hepatitis B e antigen,HBeAg)阳性、孕前超重,OR分别为5.123(95%CI:1.422~18.413)、4.619(95%CI:1.225~17.534)、3.343(95%CI:1.233~9.092)。结论对于HBsAg和HBeAg双阳性的超重/肥胖孕妇,其新生儿可能发生HBV宫内感染,应加强自身防护措施,合理规避HBV宫内感染风险。Objective To investigate the prevalence of hepatitis B virus（ HBV） infection in pregnant women and the risk factors for Intrauterine infection of HBV among pregnant women in Xiamen. Methods Total 1 064 pregnant women were included in this study. A questionnaire was performed to collect the general information of the subjects and HBV infection status was tested on the first day when they came to the hospital. Then HBs Ag positive pregnant women were selected and followed until delivery. We collected their cord blood and placenta tissue when they delivery. HBs Ag and HBV DNA in cord blood and HBs Ag in placental tissue were detected. Chi-square test and the non-conditional Logistic regression analysis were conducted to investigate the correlation between HBV intrauterine infection and risk factors. Results179 out of the 1 064 pregnant women were HBs Ag positive. The infection rate was 16. 8%. 34 out of 179 HBs Ag positive pregnant women were found intrauterine transmission with a rate of 19. 0%. The risk factors for the occurrence of HBV intrauterine transmission were placenta HBs Ag positive（ OR = 5. 123,95% CI： 1. 422-18. 413）,mothers with hepatitis B e antigen（ HBe Ag） positive（ OR = 4. 619,95% CI： 1. 225-17. 534） and overweight（ OR = 3. 343,95% CI： 1. 233-9. 092）,respectively. Conclusions Placenta HBs Ag positive,mothers with HBe Ag positive and overweight are independent risk factors for the occurrence of HBV intrauterine transmission.

关 键 词：肝炎病毒 乙型 危险因素 病例对照研究 

分 类 号：R373.21[医药卫生—病原生物学] R181[医药卫生—基础医学]