重庆市渝北区乙型肝炎病毒母婴传播阻断效果及其影响因素分析

Effect of mother-to-child transmission interruption of hepatitis B virus and its influencing factors in Yubei District of Chongqing

目的探讨乙型肝炎(乙肝)病毒表面抗原(HBsAg)阳性母亲所生新生儿乙肝疫苗(HepB)与乙肝免疫球蛋白(HBIG)联合免疫后母婴传播阻断效果及影响因素。方法选取2016年6月至2019年5月重庆市渝北区妇幼保健院、重庆市渝北区区人民医院、重庆市渝北区区中医院开展现场监测工作、经产前筛查检测乙肝表面抗原阳性母亲及新生儿638例,获随访220例。采取HepB与HBIG联合免疫和HepB全程免疫的措施后检测婴儿血清HBsAg和抗乙肝病毒表面抗体(HBsAb),分析乙肝母婴传播阻断效果及影响因素。结果220例HBsAg阳性母亲所生新生儿HepB1、HepB联合HBIG、HepB1-3接种率分别为99.1%(218/220)、99.1%(218/220)、99.1%(218/220);全程免疫后婴儿HBsAg阳性率为0.5%(1/220),母婴传播阻断成功婴儿HBsAb阳性率为97.3%(214/220)。不同HBsAg阳性母亲年龄、胎次、新生儿出生体重、喂养方式婴儿HBsAg阳性率比较,差异均无统计学意义(P>0.05)。结论HepB与HBIG联合免疫措施对HBsAg阳性母亲所生新生儿乙肝母婴传播阻断效果显著。

Objective To investigate the effect of and influencing factors the interruption of mother-to-child transmission after combined immunization with hepatitis B vaccine(HepB)and hepatitis B immunoglobulin(HBIG)in newborns born to hepatitis B(HB)virus surface antigen(HBsAg)-positive mothers.Methods A total of 638 cases of hepatitis B surface antigen-positive mothers and newborns tested by prenatal screening in Maternal and Child Health Hospital,People′s Hospital,and Chinese Hospital of Yubei District from June 2016 to May 2019 were enrolled as the participants and 220 cases were followed up.The serum HBsAg and anti-hepatitis B virus surface antibody(HBsAb)of infants were detected after combined immunization with HepB and HBIG and full immunization with HepB.The effect of blocking mother-to-child transmission of hepatitis B and the influencing factors were analyzed.Results The vaccination rates of HepB1,HepB combined with HBIG and HepB1-3 in the 220 newborns born to HBsAg-positive mothers were 99.1%(218/220),99.1%(218/220)and 99.1%(218/220)respectively.The infant HBsAg positivity rate after full immunization was 0.5%(1/220).The rate of HBsAb positivity in infants with successful MTCT interruption was 97.3%(214/220).There were no statistically significant differences(P>0.05)when comparing the HBsAg positive rate of infants with different HBsAg positive mothers in terms of age,gestational age,newborn birth weight and feeding method.Conclusion The combined immunization measure of HepB and HBIG was effective in blocking mother-to-child transmission of hepatitis B in newborns born to HBsAg-positive mothers.