北京市孕产妇乙型肝炎病毒感染的流行病学特点及妊娠结局分析  

Epidemiological characteristics and pregnancy outcome analysis of maternal hepatitis B virus infections in Beijing

作　　者：张雪[1] 于莹[1] 陈正超 刘凯波[1] ZHANG Xue;YU Ying;CHEN Zhengchao;LIU Kaibo(Beijing Obstetrics and Gynecology Hospital,Capital Medical University/Beijing Maternal and Child Health Care Hospital,Perinatal Health Care Department,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院围产保健科,北京100026

出　　处：《中国妇幼健康研究》2022年第12期75-79,共5页Chinese Journal of Woman and Child Health Research

基　　金：首都卫生发展科研专项资助(2022-2G-2118)。

摘　　要：目的探讨乙型肝炎病毒(HBV)感染孕妇的流行病学特征及妊娠合并HBV感染对不良妊娠结局的影响,评估北京市HBV母婴传播率。方法采用回顾性研究方法,收集2020年“北京市围产保健管理登记卡”中填报乙型肝炎表面抗原(HBsAg)结果的孕产妇资料,共计155970例,比较HBsAg阳性(n=4246)和HBsAg阴性孕产妇(n=151724)的社会经济人口学指标、不良妊娠结局,计算HBsAg阳性孕产妇的母婴传播率。结果多因素Logistic分析显示,年龄较大是影响孕产妇发生乙肝的危险因素(OR>1,P<0.05),而学历较高和本市户籍是影响孕产妇发生乙肝的保护因素(OR<1,P<0.001)。乙肝感染可增加早产发生风险,差异有统计学意义(OR=1.14,95%CI:1.01~1.29)。HBsAg阳性孕妇的HBV母婴传播率为0.10%(95%CI:0.02%~0.28%)。结论孕产妇HBV感染率随社会经济水平增高而下降;HBV感染可增加早产发生风险。规范实施预防HBV母婴传播的综合干预措施后,其母婴传播率可以基本达到世界卫生组织的指标要求。Objective To explore the epidemiological characteristics of pregnant women infected with hepatitis B virus(HBV)and the impact of pregnancy combined with HBV on adverse pregnancy outcomes,and to evaluate the mother-to-child transmission rate of HBV in Beijing.Methods The data of 155970 pregnant women who reported the results of hepatitis B surface antigen(HBsAg)in the“Beijing Perinatal Health Care Management Registration Card”in 2020 were collected by retrospective study,the socioeconomic demographic indicators,adverse pregnancy outcomes of HBsAg-positive pregnant women(n=4246)and HBsAg-negative pregnant women(n=151724)were compared,and the mother-to-child transmission rate of HBsAg-positive pregnant women was calculated.Results Multivariate Logistic analysis showed that older age was the risk factor affecting the occurrence of hepatitis B in pregnant women(OR>1,P<0.05),while higher education and household registration in the city were the protective factors affecting the occurrence of hepatitis B in pregnant women(OR<1,P<0.001).Hepatitis B infection could increase the risk of preterm birth,and the difference was statistically significant(OR=1.14,95%CI:1.01-1.29).The mother-to-child transmission rate of HBV in HBsAg-positive pregnant women was 0.10%(95%CI:0.02%-0.28%).Conclusion The prevalence of HBV infection in pregnant women decreases with the increase of socioeconomic level;HBV infection can increase the risk of preterm birth.After standardized implementation of the comprehensive intervention measures to prevent mother-to-child transmission of HBV,the mother-to-child transmission rate can basically meet the requirements of the World Health Organization.

关 键 词：乙型肝炎病毒 社会经济学 妊娠结局 母婴传播 

分 类 号：R173[医药卫生—妇幼卫生保健]