不同分娩方式对乙肝高病毒血症母婴垂直传播的影响

The influence of different delivery modes to HBV mother-to-child vertical transmission

目的:探讨剖宫产分娩能否降低乙肝高病毒血症孕妇母婴垂直传播发生率。方法:根据乙肝孕妇HBV-DNA滴度分为<103cps/ml、103~105cps/ml、105~107cps/ml和≥107cps/ml 4组,比较各组中经阴分娩及未临产剖宫产分娩的新生儿的HBV阳性率。结果:未临产剖宫产组、经阴分娩组的新生儿HBV总体阳性率分别为6.2%和10.3%,差异无统计学意义(P>0.05)。乙肝孕妇HBV-DNA<107cps/ml时,经阴分娩与未临产剖宫产出生的新生儿HBV阳性率比较,差异无统计学意义(P>0.05)。乙肝孕妇HBV-DNA≥107cps/ml时,剖宫产出生的新生儿HBV阳性率显著低于经阴分娩(4.4%vs37.8%,P<0.05﹚。结论:HBV-DNA≥107cps/ml的乙肝高病毒血症孕妇,未临产剖宫产可能降低乙型肝炎病毒母婴垂直传播率,应建立个性化乙肝母婴垂直传播防治方案。

Objective:To investigate whether the cesarean section can block HBV vertical transmission.Methods:Pregnant women carrying Hepatitis B virus were divided into four groups with HBV-DNA concentration,<10~3cps/ml,10~3~ 10~5 cps/ml,10~5~ 10~7 cps/ml,and ≥10~7cps/ml.The HBV positive rate of infants born through natural delivery and cesarean section was compared.Results:The HBV positive rates of infants born through natural delivery and cesarean section were respectively 6.2% and 10.3%.The differences were statistically significant.In the HBV-DNA concentration between 0copy/ml and 10~7 copy/ml,Hepatitis B positive rates of the neonatal in the natural delivery and cesarean section group were no significant difference(P>0.05).In the HBV-DNA concentration≥10~7copy/ml,hepatitis B positive rate of the neonatal in the cesarean section group was lower than that in the natural delivery group(P<0.05).The differences were statistically significant.Conclusion:Cesarean section would benefite pregnant women carrying Hepatitis B virus with HBV-DNA concentration ≥10~7cps/ml,by reducing the HBV infection rate of infants when giving birth to children.Therefore a personalized control scheme for HBV vertical transmission needs to build up.