高HBV载量孕妇分娩方式与其新生儿2h HBV感染的临床研究

CLINICAL STUDY ON THE RELATIONSHIP BETWEEN DELIVERY STYLES OF PREGNANT WOMEN WITH HIGH CAPACITY OF HBV AND HBV INFECTION OF 2 HOUR-OLD NEWBORNS

[目的]探讨高HBV载量孕妇分娩方式与其新生儿2hHBV感染的关系。[方法]以PCR荧光定量法检测孕妇及新生儿血清HBV-DNA定量,采用电化学免疫发光法检测新生儿血清HBV-M。[结果]将273例血清HBV-DNA载量﹥1×105拷贝/ml的孕妇按分娩方式及分娩时间分为3组,A组:择期剖宫产组151例,分娩新生儿153例,B组:宫口开大2+cm以上因产科因素行剖宫产组68例,分娩新生儿69例,C组:阴道分娩组54例,分娩新生儿54例,新生儿生后2h内股静脉血HBsAg和(或)HBV-DNA阳性率分别为9.15%(14/153),18.84%(13/69),27.78%(15/54),组间阳性率差别有统计学意义。[结论]高HBV-DNA载量孕妇所产新生儿生后2h内HBV感染与分娩方式及分娩时间有关,阴道分娩及临产后剖宫产较择期剖宫产的感染率高。

[Objective] To explore the relationship between delivery, styles of pregnant women with high capacity of HBV and HBV infection of the 2 hour-old newborns. [Methods] The capacity of HBV-DNA in serum of pregnant women and new-borns was detected by fluorescence quantitative PCR （FQ-PCR）, and the HBVM in serum of newborns was detected by electrochemiluminescence immunoassay （ECLIA）. [ Results] 273 Pregnant women with the capacity of HBV-DNA above 1×lO^5 copy/ml were divided into three groups according to their delivery styles and delivery time. Group A： 151 pregnant women with elective cesarean section and 153 newborns; Group B： 68 pregnant women of cesarean section with the cervix more than 2 cm dilated due to obstetric factors and 69 newborns. Group C ： 54 pregnant women with vaginal delivery and 54 newborns. The positive rates of HBsAg and/or HBV-DNA in serum of newborns for group A, B and C were 9.15% （14/153）, 18.84% （13/69） and 27.78% （15/54）, respectively. Significant difference was found among the three groups. [Conclusion] HBV infection of the 2 hour-old newborns hear by pregnant women with higher capacity of HBV-DNA is significantly associated with the delivery styles and delivery time, and the infective rate of pregnant women with vaginal delivery and cesarean section after labor starts reveal was significantly higher than that of pregnant women with elective cesarean section.