Vaginal Delivery and Breastfeeding Benefit Infant Immune Response to Hepatitis B Vaccine:A Prospective Cohort Study  

作　　者：Huiqing Liu Lili Li Yali Li Minmin Liu Yarong Song Feng Ding Xiaoshu Zhang Jie Li 

机构地区：[1]Jinchang Municipal Center for Disease Control and Prevention,Jinchang,Gansu,China [2]Department of Microbiology&Infectious Disease Center,School of Basic Medical Sciences,Peking University Health Science Center,Beijing,China [3]Gansu Provincial Center for Disease Control and Prevention,Lanzhou,Gansu,China

出　　处：《Journal of Clinical and Translational Hepatology》2023年第4期899-907,共9页临床与转化肝病杂志（英文版）

基　　金：This study was supported by grants from the Chinese Foundation for Hepatitis Prevention and Control(YGFK20180006).

摘　　要：Background and Aims:Natural vaginal delivery and breastfeeding favor the development of a strong immune system in infants,and the immune response of infants to vaccines is closely related to their immune system.This large prospective cohort study aimed to explore the effects of delivery and feeding mode on infant’s immune response to hepatitis B vaccine(HepB).Methods:A total of 1,254 infants who completed the whole course of HepB immunization and whose parents were both HBsAg negative were enrolled from infants born in Jinchang City during 2018-2019 by cluster sampling method.Results:Twenty(1.59%)of the 1,254 infants were nonresponders to HepB.Among the other 1,234 infants,10.05%(124/1,234),81.69%(1,008/1,234)and 8.27%(102/1,234)of infants had low,medium,and high responses to HepB,respectively.Logistic regression analysis showed that cesarean section(OR:8.58,95%CI:3.11-23.65,p<0.001)and birth weight<3.18 kg(OR:5.58,95%CI:1.89-16.51,p=0.002)were independent risk factors for infant nonresponse to HepB,and cesarean section(OR:7.63,95%CI:4.64-12.56,p<0.001),formula feeding(OR:4.91,95%CI:1.47-16.45,p=0.001),maternal antiHBs negativity(OR:27.2,95%CI:10.67-69.35,p<0.001),paternal non-response history of HepB(OR:7.86,95%CI:2.22-27.82,p=0.014)and birth weight<3.22 kg(OR:4.00,95%CI:2.43-6.59,p<0.001)were independent risk factors for infant low response to HepB.In cases where birth weight and genetic factors are unmodifiable and maternal anti-HBs effects are controversial,it makes sense to enhance infant response by changing delivery and feeding patterns.Conclusions:Natural vaginal delivery and breastfeeding are beneficial to the infant’s immune response to HepB.

关 键 词：Hepatitis B vaccine Immune response ANTI-HBS Vaginal delivery BREASTFEEDING 

分 类 号：R17[医药卫生—妇幼卫生保健] R186[医药卫生—公共卫生与预防医学]