在联合免疫阻断下分娩方式对乙型肝炎病毒母婴传播的影响

The effect of the delivery modes under the combined immunization blocking on the maternal-infant transmission of hepatitis B virus

目的探讨在联合免疫阻断下不同分娩方式对母婴传播的影响。方法从张家港市所有设产科的医院选取母亲为乙肝病毒表面抗原(HBsAg)阳性且已接种乙肝疫苗和乙肝免疫球蛋白的婴幼儿510人,随访调查母亲乙肝病毒感染情况、分娩方式等,并检测婴幼儿血清中HBsAg水平。结果调查婴幼儿中,阴道顺产HBsAg阳性率为2.97%,剖宫产HBsAg阳性率为0.73%,不同分娩方式对婴幼儿HBV感染率的影响差异无统计学意义(χ~2=2.481,P>0.05)。结论无论是HBV感染单阳还是双阳性的母亲,所生新生儿在采取联合免疫措施后自然分娩与剖宫产的新生儿HBV感染差异无统计学意义,说明剖宫产并不能减少HBV的母婴传播。因此,不能以阻断HBV母婴传播为目的而选择剖宫产分娩。

Objective To explore the effect of different delivery modes on the maternal - infant infection of hepatitis B virus under the combined immunization blocking of hepatitis B vaccine and hepatitis B immunoglobulin. Methods 510 infants born by mothers with positive hepatitis B surface antigen （HBsAg） and inoculated by hepatitis B vaccine and hepatitis B immunoglobulin were sampled from all of the hospitals with the obstetrical departments in Zhangjiagang City. A follow - up survey including the mother＇ s virus infection, delivery modes, etc. The infants＇ venous blood was collected to test the level of HBsAg in serum. Results The positive rate of HBsAg was 2. 97% and 0. 73% among the infants delivered by vaginal and Cesarean section, respectively, which did not show any statistical differences between different delivery modes （χ2 = 2. 481, P 〉 0.05 ）. Conclusion No statistically significant differences were found between the newborn babies born by natural birth and cesarean section after blocking of combined immunization, whether their mothers were single or double HBV positive, which means cesarean section could not reduce the maternal - infant transmission of hepatitis B. So you cant aim at blocking mother - to - child transmission of HBV and choose cesarean section delivery. Therefore, people should not choose the cesarean section for the purpose of blocking maternal - infant transmission of HBV.