2018-2019年宝鸡市私营医院孕妇传染性病原体检测结果及母婴阻断现状调查

Investigation on detection results of infectious pathogens in pregnant women and current status of mother-to-child transmission blocking service in private hospitals of Baoji City from 2018 to 2019

目的调查2018—2019年宝鸡市私营医院孕妇传染性病原体检测情况,并评估母婴阻断服务现状。方法收集2018年1月至2019年12月宝鸡市私营医院4903例孕产妇就诊信息,利用国家预防艾滋病、梅毒和乙肝母婴传播管理信息系统,记录4903例孕产妇艾滋病、梅毒和乙肝(简称三病)检测结果及孕产妇人口学特征,并记录三病阳性孕产妇及新生儿用药情况和母婴阻断成功率。结果4903例孕产妇艾滋病、梅毒和乙肝检测率均为99.78%,未检出艾滋病阳性,梅毒和乙肝阳性率分别为0.61‰、1.86%。因艾滋病、梅毒阳性例数过少,仅对乙肝孕产妇作人口学特征分析,乙肝孕产妇年龄以21~35岁居多,受教育程度以初中及以下居多,职业以服务业、其他/无业居多,婚姻状况及户籍以已婚和本地居民居多,以孕期确诊为主。梅毒孕妇孕期用药率及活产新生儿用药率均为100.00%;乙肝孕妇孕期乙肝DNA定量检测率为24.2%,用药率为69.23%,多数为保肝药物,抗病毒药物使用率仅为2.2%,活产新生儿生后24 h乙肝免疫球蛋白及乙肝疫苗注射率为100%。梅毒产妇有1例失访,失访率为33.33%,乙肝产妇有10例失访及1例拒查,失访率为12.1%,随访婴幼儿出生后均按照母婴阻断方案用药治疗,梅毒、乙肝母婴阻断成功率均为100.00%。结论宝鸡市私营医院孕妇艾滋病、梅毒、乙肝检测率较高,但乙肝DNA定量检测率偏低,不利于病情评估及监测,随访婴幼儿母婴阻断成功率高,但失访例数较多,需引起医院重视。

Objective To investigate the detection status of infectious pathogens in pregnant women in private hospitals of Baoji City from 2018 to 2019,and to assess the current status of mother-to-child transmission blocking service.Methods The medical information of 4903 pregnant and lying-in women in private hospitals of Baoji City were collected between January 2018 and December 2019.The detection results of acquired immunodeficiency syndrome(AIDS),syphilis,and hepatitis B(referred to as the three diseases)of 4903 cases of pregnant and lying-in women and the demographic characteristics of pregnant and lying-in women were recorded by using the national mother-to-child transmission management information system for the prevention of AIDS,syphilis,and hepatitis B.And the medication use of pregnant and lying-in women with positive three diseases and neonates and success rate of mother-to-child transmission blocking were recorded.Results The detection rates of AIDS,syphilis,and hepatitis B in 4903 pregnant and lying-in women were all 99.78%.No positive AIDS was found,and the positive rates of syphilis and hepatitis B were 0.61‰and 1.86%,respectively.Due to the small number of positive cases of AIDS and syphilis,only the demographic characteristics of pregnant and lying-in women with hepatitis B were analyzed.The pregnant and lying-in women with hepatitis B were mostly with age of 21 to 35 years old,education level of junior high school and below,occupation of service industry and other/unemployed,marital status of married status,and household registration of local residents,and most of them were diagnosed during pregnancy.The medication use rates of pregnant and lying-in women with syphilis during pregnancy and neonates were both 100.00%.The rate of quantitative detection of hepatitis B DNA in pregnant women with hepatitis B during pregnancy was 24.2%,and the medication use rate was 69.23%;most of them were hepatoprotective drugs,and the use rate of antiviral drugs was only 2.2%.The injection rate of hepatitis B immune globulin and hepatitis B vaccine was 100%for live-born neonates at 24 hours after birth.One case of syphilis mother was lost to follow-up,with the loss rate of 33.33%.Ten cases of hepatitis B mothers were lost to follow-up and 1 case refused to be investigated,with the loss rate of 12.1%.Follow-up infants were treated according to the mother-to-child transmission blocking regimen after birth,and the success rates of mother-to-child transmission blocking of syphilis and hepatitis B were both 100.00%.Conclusion The detection rates of AIDS,syphilis,and hepatitis B of pregnant and lying-in women in private hospitals of Baoji City are relatively high,but the quantitative detection rate of hepatitis B DNA is low,which is not conducive to disease assessment and monitoring.The success rate of mother-to-child transmission blocking in infants is high,but there are many cases lost to follow-up,which needs to be paid attention by hospitals.