广东省母亲乙型肝炎表面抗原阳性新生儿乙型肝炎疫苗接种情况及影响因素分析  

Analysis of hepatitis B vaccination status and influencing factors among newborns of hepatitis B surface antigen-positive mothers in Guangdong Province

作　　者：喻晨殊 甘玉杰[3] 蔡敏 张婉雪 高爽[4] 崔富强[1,2] YU Chenshu;GAN Yujie;CAI Min;ZHANG Wanxue;GAO Shuang;CUI Fuqiang(Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing100191,China.;不详)

机构地区：[1]北京大学公共卫生学院流行病与卫生统计学系,北京100191 [2]北京大学公共卫生学院卫生检验学系疫苗研究评价中心 [3]广东省中山市博爱医院 [4]广东省妇幼保健院

出　　处：《中国预防医学杂志》2025年第1期93-101,共9页Chinese Preventive Medicine

摘　　要：目的探讨广东省乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阳性母亲新生儿的乙型肝炎疫苗(hepatitis B vaccine,HepB)接种情况和影响因素,为HepB接种提供参考。方法收集2020年1月—2021年12月广东省HBsAg阳性母亲新生儿完整的HepB接种数据,分析接种情况,并采用多因素logistic回归分析影响接种及时性的因素。结果纳入研究的21941例新生儿中,HepB全程接种百分比为96.46%,首剂次接种比例为99.98%,首剂次及时接种百分比为85.19%。对体质量<2000 g的新生儿,四剂次全程接种比例仅为10.53%。多因素分析显示,首针及时接种的保护因素为母亲职业为生产制造及有关人员(OR=1.61,95%CI:1.08~2.40);而未检测HBV DNA(OR=0.56,95%CI:0.47~0.66)、在乡(街道)级助产机构分娩(OR=0.53,95%CI:0.43~0.64)、择期剖宫产(OR=0.73,95%CI:0.58~0.90)、出生时间在下午(OR=0.13,95%CI:0.11~0.16)和晚上(OR=0.14,95%CI:0.11~0.17)首剂次及时接种的可能性降低。全程及时接种的保护因素包括母亲学历为大专或大学、硕士及以上(OR=1.31,95%CI:1.17~1.46)、HBV DNA检测结果高于检测下限(OR=1.18,95%CI:1.02~1.36);而母亲职业为农、林、牧、渔业及辅助人员(OR=0.77,95%CI:0.62~0.96),母亲产次≥3次(OR=0.57,95%CI:0.36~0.90)、分娩地点在乡(街道)级助产机构(OR=0.82,95%CI:0.71~0.94)、自然分娩(OR=0.87,95%CI:0.78~0.96)、出生时间在下午(OR=0.61,95%CI:0.54~0.68)和晚上(OR=0.62,95%CI:0.55~0.69)的婴儿更难保证全程及时接种。结论广东省HBsAg阳性母亲新生儿HepB接种比例较高,但及时性仍有提升空间,低体质量儿童的接种及时性需要加强。母亲的文化程度、职业、分娩地点和新生儿出生时间等因素影响接种及时性,建议针对这些因素开展针对性教育和管理,以提高接种及时性。Objective To investigate the vaccination status and influencing factors of hepatitis B vaccine(HepB)in newborns of mothers positive for hepatitis B surface antigen(HBsAg)in Guangdong Province,providing a reference for HepB vaccination.Methods Data on newborns from HBsAg-positive mothers in Guangdong Province with complete HepB vaccination records from January 2020 to December 2021 were collected.The vaccination status was analyzed,and multifactor logistic regression was used to analyze factors affecting vaccination timeliness.Results Among the 21941 newborns included in the study,the percentage of complete HepB vaccination was 96.46%,the proportion of first dose vaccination was 99.98%,and the percentage of timely first dose vaccination was 85.19%.For newborns with birth weight<2000 g,only 10.53%received all four doses of the complete vaccination series.Multivariate analysis revealed that mothers employed in manufacturing and related occupations were a protective factor for the timely administration of the first dose(OR=1.61,95%CI:1.08-2.40).Factors associated with a decreased likelihood of timely first dose administration included:undetected HBV DNA(OR=0.56,95%CI:0.47-0.66),delivery at township/street-level birthing facilities(OR=0.53,95%CI:0.43-0.64),elective cesarean section(OR=0.73,95%CI:0.58-0.90),and birth time in the afternoon(OR=0.13,95%CI:0.11-0.16)or evening(OR=0.14,95%CI:0.11-0.17).Protective factors for timely complete vaccination included mothers with a college degree or higher(OR=1.31,95%CI:1.17-1.46)and HBV DNA levels above the detection limit(OR=1.18,95%CI:1.02-1.36).However,mothers working in agriculture,forestry,animal husbandry,fishery,and auxiliary occupations(OR=0.77,95%CI:0.62-0.96),mothers with three or more deliveries(OR=0.57,95%CI:0.36-0.90),delivery at township/street-level maternity institutions(OR=0.82,95%CI:0.71-0.94),vaginal delivery(OR=0.87,95%CI:0.78-0.96),and births occurring in the afternoon(OR=0.61,95%CI:0.54-0.68)or evening(OR=0.62,95%CI:0.55-0.69)were less likely to ensure time

关 键 词：乙型肝炎疫苗 接种及时性 乙型肝炎表面抗原 影响因素 新生儿 母亲 

分 类 号：R186[医药卫生—流行病学]