河南省新郑市HBV感染孕妇母婴阻断效果及乙肝相关知识知晓情况调查

Status of Hepatitis B related knowledge and mother-to-child transmission prevention in pregnant women with HBsAg positive in Xinzheng,Henan

目的 了解乙肝相关知识的知晓情况,分析HBV感染孕妇母婴阻断影响因素,为提高母婴阻断效果提供参考。方法 对2018年5月至2019年10月在河南省新郑市所有医院孕产妇HBV感染情况进行筛查和登记,对参与母婴阻断效果研究的对象进行问卷调查,主要内容包括一般人口学信息和乙肝相关知识。实验室检测HBsAg、HBeAg、HBe Ab和HBV DNA。新生儿出生后按照0-1-6月接种乙肝疫苗,在完成全程接种1个月后采集标本,检测HBsAg和HBsAb进行母婴阻断分析。结果 共计调查孕妇18 522名,其中HBV感染占2.8%(528/18 522),参与母婴阻断的192名HBV感染孕妇,平均年龄为(28.9±3.7)岁,大专以上文化程度占45.3%。HBeAg阳性孕妇占29.4%,HBV DNA载量高于2×105 IU/mL的占21.3%,HBV感染孕妇关于乙肝知识的知晓率为83.3%,母婴阻断成功率为97.4%,其中HBeAg(-)和HBeAg(+)母亲所生新生儿母婴阻断成功率分别为100.0%和91.2%,差异有统计学意义(P=0.002),新生儿HBsAb阳性率分别为95.6%和87.7%,差异有统计学意义(χ^(2)=3.899,P=0.048);孕妇HBV DNA载量HBV DNA≥2×10^(5)和<2×10^(5)IU/mL阻断成功率分别是87.7%和100.0%,差异有统计学意义(P=0.000 36)。结论 HBV感染孕妇母婴阻断成功率与HBe Ag阳性与否及病毒载量高低直接相关,提高孕妇乙肝相关知识知晓率,有针对性的进行抗病毒治疗,降低HBV复制活性,是提高母婴阻断成功率的关键。

Objective To understand the knowledge of hepatitis B related knowledge,analyze the influencing factors of maternalinfant blockade in pregnant women with HBV infection,and provide reference for improving the effect of maternal-infant blockade.Methods The HBV infection status of pregnant and lying-in women in all hospitals in Xinzheng city,Henan province from May 2018 to October 2019 was screened and registered,and a questionnaire survey was conducted on the subjects who participated in the study on the effect of mother-to-child interruption.The main contents included general demographic information and Hepatitis B related knowledge.HBsAg,HBeAg,HBeAb and HBV DNA were tested.Newborns were vaccinated with hepatitis B vaccine from 0 to 1 to 6 months after birth.Specimens were collected one month after the whole course of vaccination to detect HBsAg and HBsAb for mother-to-child blocking analysis.Results A total of 18 522 pregnant women were investigated,of which HBV infection accounted for 2.8%(528/18 522),and 192 HBV-infected pregnant women who participated in the mother-to-child interruption were surveyed,with an average age of(28.9 ±3.7) years old,and 45.3% with a college degree or above.HBeAg-positive pregnant women accounted for 29.4%,HBV DNA load being higher than 2×10~5IU/mL accounted for 21.3%,the awareness rate of HBV-infected pregnant women about hepatitis B knowledge was 83.3%,and the success rate of mother-to-child blocking was 97.4%.Among them,the success rates of mother-to-infant blockade of neonates born to HBeAg(-) and HBeAg(+) mothers were 100.00% and 91.2%,respectively,with a statistically significant difference(P<0.002).The positive rates of neonatal HBsAb were 95.6% and 87.7%,respectively,the difference was statistically significant(χ~2=3.899,P=0.048).Pregnant women with HBV DNA load HBV DNA ≥ 2×10~5 and HBV DNA<2×105IU/mL had a successful blocking rate of 87.7% and 100.0%,respectively,and the difference was statistically significant(P=0.000 36).Conclusion The success rate of mother-to-child blockade in pregnant women with HBV infection is directly related to whether HBeAg is positive or not and the level of viral load.Improving the awareness rate of hepatitis B-related knowledge in pregnant women,targeted antiviral treatment,and reducing HBV replication activity are the key to improve maternal-infant resistance.