湖南省乙型肝炎病毒感染孕产妇早产、低出生体重和小于胎龄儿发生率及相关因素分析  

Incidence and related factors of preterm delivery, low birth weight, and small for gestational age infants in pregnant women with hepatitis B virus infection in Hunan Province

作　　者：李辉霞[1] 谭丹凤[1] 肖娟[1] 郑剑飞[2] 涂颖 高洁[1] 杨敏[1] LI Hui-xia;TAN Dan-feng;XIAO Juan;ZHENG Jian-fei;TU Ying;GAO Jie;YANG Min(Department of Child Health,Hunan Maternal and Child Health Hospital,Changsha,Hunan 410008,China;不详)

机构地区：[1]湖南省妇幼保健院儿童保健科,湖南长沙410008 [2]中南大学湘雅二医院急诊科 [3]中南大学湘雅公共卫生学院儿少卫生与妇幼保健学系

出　　处：《现代预防医学》2023年第19期3512-3518,共7页Modern Preventive Medicine

基　　金：湖南省自然科学基金项目(2020JJ5285)。

摘　　要：目的 了解湖南省乙型肝炎病毒(hepatitis B virus, HBV)感染孕产妇早产、低出生体重(low birth weight, LBW)和小于胎龄儿(small for gestational age, SGA)的发生状况并探讨相关影响因素。方法 以2021年1—12月在湖南省各助产机构分娩并上报预防乙型肝炎母婴传播信息系统的HBV感染孕产妇为研究对象,对其人口学特征、妊娠情况、乙肝病毒相关检测及治疗等因素进行分析,分别计算早产、LBW和SGA发生率,采用多因素logistic回归分析其影响因素。结果 共纳入28 100例HBV感染孕产妇,其早产率为6.8%(1 899/28 100),LBW发生率为4.4%(1 224/28 100),SGA发生率为6.9%(1 931/28 100)。HBV感染孕产妇早产的危险因素包括孕产妇年龄(与25~29岁相比)为30~34岁和≥35岁、首次产前检查孕周≥28周(与1~12周相比)、孕期抗病毒治疗,其调整的优势比(adjusted odds ratio, aOR)分别为1.40(95%CI:1.23~1.60)、1.97(95%CI:1.70~2.28)、1.15(95%CI:1.03~1.28)、1.36(95%CI:1.16~1.59)。孕产妇年龄<20岁、30~34岁、≥35岁和孕期抗病毒治疗是LBW的危险因素,其aOR值分别为1.75(95%CI:1.08~3.16)、1.32(95%CI:1.13~1.54)、1.88(95%CI:1.57~2.25)、1.35(95%CI:1.12~1.63)。孕产妇年龄<20岁、20~24岁和孕期抗病毒治疗是SGA的危险因素,其aOR值分别为1.92(95%CI:1.24~2.97)、1.34(95%CI:1.14~1.56)、1.26(95%CI:1.07~1.48)。有生产经历是早产、LBW和SGA共同的保护因素,其aOR值分别为0.75(95%CI:0.67~0.85)、0.68(95%CI:0.59~0.78)和0.82(95%CI:0.73~0.92)。结论 湖南省HBV感染孕产妇早产、LBW和SGA的发生率不高,但仍受到孕产妇年龄、产次、首次产前检查时间和孕期抗病毒治疗等因素影响。Objective To investigate the incidence of preterm delivery, low birth weight low birth weight (LBW), and small for gestational age (SGA) in pregnant women with hepatitis B virus (HBV) infection in Hunan Province and to explore the related factors. Methods The pregnant women with HBV infection who delivered from January to December, 2021 in various midwifery institutions in Hunan Province and reported to the communication system of mother-to-child transmission of hepatitis B were investigated. Their demographic characteristics, pregnancy, hepatitis B virus-related detection, and treatment were analyzed. The incidences of preterm delivery, LBW, and SGA were calculated respectively. Multivariate logistic regression was used to analyze the influencing factors. Results A total of 28 100 pregnant women with HBV infection were included, with a premature delivery rate of 6.8% (1 899/28 100), LBW rate of 4.4% (1 224 /28 100), and SGA rate of 6.9% (1 931/28 100). Risk factors for preterm delivery in pregnant women with HBV infection included maternal age of 30 to 34 years and ≥ 35 years (compared with 25 to 29 years old), gestational age of the first antenatal examination ≥ 28 weeks (compared with 1 to 12 weeks), and antiviral therapy during pregnancy. The adjusted odds ratios (aOR) were 1.40 (95%CI: 1.23-1.60), 1.97 (95%CI: 1.70-2.28), 1.15 (95%CI: 1.03-1.28), and 1.36 (95%CI:1.16-1.59), respectively. Maternal age < 20 years old, 30 to 34 years old, and ≥ 35 years old, and antiviral therapy during pregnancy were risk factors for LBW, and their aOR values were 1.75 (95%CI: 1.08-3.16), 1.32 (95%CI: 1.13-1.54) and 1.88 (95%CI: 1.57-2.25), 1.35 (95%CI: 1.12-1.63), respectively. Maternal age < 20 years old, 20 to 24 years old, and antiviral therapy during pregnancy were risk factors for SGA, and their aOR values were 1.92 (95%CI: 1.24-2.97) and 1.34 (95%CI: 1.14-1.56), and 1.26 (95%CI: 1.07-1.48), respectively. Birth experience was a common protective factor for preterm delivery, LBW, and SGA, and their aOR values were 0

关 键 词：乙型肝炎病毒 孕产妇 不良妊娠结局 早产 低出生体重 

分 类 号：R714.251[医药卫生—妇产科学]