新生儿乙肝病毒母婴传播阻断效果及影响因素分析

Analysis of the detection results and influencing factors of the blocking effect of mother-to-child transmission of neonatal hepatitis B virus

目的分析新生儿乙肝病毒(HBV)母婴传播阻断效果及影响因素。方法回顾性分析2019年1月—2021年2月于上饶市广信区妇幼保健院行产前筛查并确认乙肝表面抗原(HBsAg)阳性的100例孕妇及其所生产的婴幼儿的临床资料,记录母婴传播阻断效果,并分析阻断失败的影响因素。结果100例婴幼儿中18例HBsAg阳性,阳性率为18.00%,母婴传播阻断成功率82.00%;85例抗-HBs阳性,阳性率为85.00%;3例抗-HBc阳性,阳性率为3.00%。经单因素分析结果显示,孕妇分娩前HBV感染情况、孕期HBIG接种情况、喂养方式和HepB接种剂量均对母婴传播阻断效果存在影响(P<0.05)。经多因素Logistic分析结果显示,孕期未接种HBIG和母乳喂养对母婴传播阻断效果无明显影响(P>0.05),而孕妇分娩前HBV阳性和HepB接种剂量为5μg×3是影响母婴传播阻断效果的独立危险因素(P<0.05)。结论新生儿HBV母婴传播阻断成功率为82.00%,孕妇分娩前HBV阳性和HepB接种剂量为5μg×3是影响母婴传播阻断失败的重要因素,而选择HepB接种剂量为10μg×3可有效提高母婴传播阻断效果。

Objective To analyze the detection results of blocking the mother-to-child transmission of neonatal hepatitis B virus(HBV)and the influencing factors of blocking failure.Methods Retrospectively analyze the clinical data of 100 cases of pregnant women and their infants who have undergone prenatal screening in our hospital from January 2019 to February 2021 and confirmed that the hepatitis B surface antigen(HBsAg)test is positive,and record the mothers and infants Check the results of the transmission blocking effect,and analyze the influencing factors of the blocking failure.Results Among 100 infants and young children,18 cases were positive for HBsAg,the positive rate was 18.00%,and the success rate of blocking mother-to-child transmission was 82.00%;85 cases were positive for anti-HBs,and the positive rate was 85.00%;3 case was positive for anti-HBc,positive The rate is 3.00%.The results of univariate analysis showed that HBV infection before delivery,HBIG vaccination during pregnancy,feeding method and HepB vaccination dose all had an impact on the effect of blocking mother-to-child transmission(P<0.05);Logistic multivariate results showed that pregnancy did not HBIG vaccination and breastfeeding had no significant effect on the blocking effect of mother-to-child transmission(P>0.05);while pregnant women with positive HBV before delivery and a HepB vaccination dose of 5μg×3 were risk factors affecting the blocking effect of mother-to-child transmission(P<0.05).Conclusion The success rate of interruption of mother-to-child transmission of neonatal HBV is 82.00%.HBV positive and HepB vaccination dose of 5μg×3 are important factors affecting the failure of mother-to-child transmission.It can effectively improve the blocking effect of mother-to-child transmission.