宁波市乙型肝炎表面抗原阳性母亲新生儿乙肝免疫球蛋白接种率调查及影响因素分析

Survey on the coverage of hepatitis B immunoglobulin administration among infants born to hepatitis B surface antigen positive mother in Ningbo

目的了解宁波市乙型肝炎表面抗原(HBsAg)阳性母亲所生新生儿乙肝免疫球蛋白接种率及影响接种率的相关因素。方法采用多重抽样的方法随机选取宁波市医院机构分娩的产妇和新生儿为调查对象,查阅出生记录,利用自制的调查表摘录乙肝免疫球蛋白接种的相关信息并计算接种率。使用SAS统计软件建立logistic回归模型,筛选影响接种率的相关因素。结果共查阅产妇及新生儿病历3 613份,产妇HBsAg筛查率为100%,其中HBsAg阳性产妇287人,产妇HBsAg携带率7.94%(287/3 613)。实际调查病历276份,HBsAg阳性产妇所生新生儿乙肝免疫球蛋白接种率为92.75%,其中12h内接种率为58.70%,24h内接种率为84.06%。多因素分析显示,产妇户籍、医院类别、医院级别是影响乙肝免疫球蛋白及时接种的因素,OR(95%CI)分别为0.438(0.205～0.933)、0.322(0.153～0.681)、0.485(0.237～0.993),而产妇户籍是影响乙肝免疫球蛋白是否接种的因素。结论宁波市乙肝免疫球蛋白接种情况较好,但12h及时接种率有待提高。

Objective To investigate the coverage of hepatitis B immunoglobulin （HBIG） usage among infants born to hepatitis B surface antigen （HBsAg） positive mother, and to analyze the related influencing factors. Methods Mothers and infants were selected by multiple random sampling in Ningbo hospitals. Based on the birth records, information about hepatitis B immunogtobulin usage were collected and entered to self-made survey tables. Logistic regression models were established using SAS software to screen the related factors influencing the HBIG administration. Results A total of 3613 medical records were reviewed, and all mothers were screened for HBsAg with the positive rate of 7.94% （287/36313） . Overall, 92.75% of infants born to HBsAg-positve mothers were given with BHIG and 58.70% were injected within 12 hours and 84.06% within 24 hours. Multivariate analysis showed that mother＇s household registration, hospital level and hospital type were the main influencing factors affecting the timely HBIG use, while mother＇s household registration was the only factor affecting the usage of HBIG. Conclusions The coverage of HBIG administration to infants of HBsAg-positive mothers is satisfying in Ningbo, but the usage within 12 hours after birth needs to be encouraged.