妊娠期病毒性肝炎对围产儿的影响

Influence of viral hepatitis in pregnancy on the newborn.

目的 探讨妊娠期病毒性肝炎对围产儿的影响。方法 测定 47名正常孕妇和 495例病毒性肝炎孕妇所生新生儿Apgar评分和出生时体重 ,并检测新生儿血清肝炎病毒标志。 结果 肝炎孕妇所生新生儿Apgar评分和出生时体重均显著低于对照组 (均P <0 .0 1 )。急性肝炎孕妇所生新生儿 1minApgar评分和出生时体重均显著低于乙型肝炎病毒 (HBV)携带和慢性肝炎组 (均P <0 .0 1 )。甲型肝炎未见宫内感染。HBV ,丙型肝炎病毒 (HCV)和戊型肝炎病毒(HEV)宫内感染率分别为 30 .0 % (87/ 2 99) ,1 1 .1 % (1 / 9)和 2 0 .8% (5/ 2 4 )。HBV感染孕妇所生宫内感染和无宫内感染新生儿Apgar评分和出生时体重间均无显著差异 (均P >0 .0 5)。 结论 妊娠期病毒性肝炎对围产儿生长发育和出生时状态有明显影响 ,急性肝炎影响尤大。HBV ,HCV和HEV均存在垂直传播。HAV垂直传播较少见。

Objective To appraise the influence of viral hepatitis in pregnancy on the newborn.Methods Apgar score and birth weight were measured in the newborns from mothers having viral hepatitis. Serologic tests for hepatitis viruses determined.Results Apgar score and birth weight of newborns from mothers with viral hepatitis were significantly lower than those born from healthy mothers, whereas the score and birth weight of newborns from mothers with acute hepatitis were lower than those with chronic hepatitis or HBV carrier (all P <0.01). Anti HAV IgM and IgG were negative in the newborns born from mothers with hepatitis A. Intrauterine infection rates of HBV, HCV and HEV were 30.0%(87/299), 11.1%(1/9) and 20.8%(5/24), respectively. No significant differences in Apgar score and birth weight were found between newborns with and without HBV intrauterine infection (all P > 0.05). Conclusion Viral hepatitis in pregnancy, especially the acute hepatitis, has an obvious influence on fetal growth and birth weight. Vertical transmission occurs in HBV, HCV and HEV infection, but much less in HAV infection. HBV intrauterine infection has little influence on fetal growth and newborn status.