乙肝表面抗原阳性孕产妇母婴阻断情况及危险因素分析

Analysis of mother to child blocking and risk factors in hepatitis B surface antigen positive pregnant women

目的 分析乙肝表面抗原(HBsAg)阳性孕产妇母婴阻断情况及危险因素,指导乙肝母婴传播防控。方法 选取2018年9月—2022年3月在广西壮族自治区桂东人民医院经产前筛查为HBsAg阳性的147例孕产妇及其所生新生儿为研究对象,统计HBsAg阳性孕产妇母婴阻断情况,并依据阻断是否成功分为失败组和成功组,对比失败组和成功组临床资料,分析影响HBsAg阳性孕产妇母婴阻断失败的相关因素。结果 147例HBsAg阳性孕产妇中母婴阻断成功135例,阻断失败12例。失败组HBeAg阳性占比为66.67%,新生儿乙肝疫苗(HepB)未全程接种及未规范接种均占25.00%,高于成功组,差异有统计学意义(P<0.05);多因素分析显示,产妇HBeAg阳性(OR=2.962,95%CI:1.0328~8.572)、新生儿HepB未全程接种(OR=3.367,95%CI:1.593~15.124)、新生儿HepB未规范接种(OR=2.916,95%CI:1.041~12.197)是影响HBsAg阳性孕产妇母婴阻断失败的相关因素(P<0.05)。结论 HBsAg阳性孕产妇母婴阻断失败与产妇HBeAg阳性、新生儿HepB未全程接种及未规范接种有关。

Objective To guide the prevention and control of mother to child transmission of hepatitis B by analyzing the situation and risk factors of mother to child interruption of pregnant women with hepatitis B surface antigen(HBsAg)positive.Methods From September 2018 to March 2022,147 pregnant women and their newborns who were positive for HBsAg by prenatal screening in Guidong People's Hospital of Guangxi Zhuang Autonomous Region were selected as the research objects.The maternal and infant blocking of HBsAg positive pregnant women were counted and divided into failure group and success group according to whether the blocking was successful or not,the clinical data of the failure group and success group was compared.The related factors affecting the failure of mother-to-infant blocking in HBsAg-positive pregnant women were also analyzed.Results Among the 147 HBsAg positive pregnant women,135 cases were successfully blocked and 12 cases were unsuccessful.In the failure group,the proportion of HBeAg positive pregnant women was 66.67%,the proportion of newborn HepB not vaccinated in the whole process and not vaccinated in the standard were all 25.00%,they were higher than those in the success group with significant differences(P0.05).Multivariate analysis showed that maternal HBeAg was positive(OR=2.962,95%CI:1.0328-8.572),neonatal HepB was not fully vaccinated(OR=3.367,95%CI:1.593-15.124),neonatal HepB was not vaccinated(OR=2.916,95%CI:1.041-12.197)were all related factors affecting the failure of mother-to-infant blocking in HBsAg-positive pregnant women(P 0.05).Conclusion The failure of mother-to-infant blocking in HBsAg positive pregnant women was related to maternal HBeAg positive,neonatal HepB not fully vaccinated and neonatal HepB not standardized.