母乳喂养在免疫阻断后HBV携带者安全性研究

Safety of breastfeeding in infants of HBV carrier mothers after combination immunoprophylaxis in both mothers and infants

目的观察孕妇及婴儿联合免疫后,乙肝病毒(HBV)携带产妇母乳喂养的安全性。方法前瞻性研究对HBV携带产妇于孕晚期行3次乙肝免疫球蛋白(HBIG)注射,新生儿出生48h、1个月、3个月分别注射乙肝免疫球蛋白和出生时及1、6个月分别接种乙肝疫苗。分娩后分为母乳喂养组(61例)和人工喂养组(68例)。结果两组孕妇HBV-DNA(+)率分别为59.0%和50.0%,新生儿脐血HBV感染率分别为9.8%和10.7%,乳汁中HBV感染率分别为47.5%,44.1%,两组间差异均无统计学意义。母乳喂养组婴儿7、12个月HBV感染率为8.2%,4.9%,而人工喂养组为7.4%,5.9%,差异亦无统计学意义。结论在孕妇及婴儿联合免疫后,母乳喂养并不增加HBV母婴传播的风险。

Objective To explore the safety of breastfeeding in infants of HBV carrier mothers after combination immunoprophylaxis in both mothers and infants.Methods HBV carrier mothers,who voluntarily enrolled in this prospective study,were given HBIG for three times in the third trimester,while infants were given HBIG（Hepatitis B immunoglobulin）in 48 hours,1 month and 3 months,as well as HBV vaccination.61 mothers chose breastfeeding,while 68 mothers chose bottle-feeding.Results There were no statistically difference between two groups in HBV-DNA positive rate in mothers（59.0%vs 50.0%）,HBV infection rate in cord blood in infants（9.8%vs 10.7%）,and HBV infection rate in breast milk（47.5%vs44.1%）.The HBV infectious rate in breastfeeding group was 8.2%,4.9%in 7 months and 12 months infants,and in bottle-feeding group it was 7.4%,5.9%respectively,with no statistically difference being noticed.Conclusion Breastfeeding pose no additional risk of HBV transmission on infants after combination immunoprophylaxis in both mothers and infants.