慢性乙型肝炎病毒感染孕妇宫内传播的发病率及危险因素分

StephenW

Journal of Clinical Gastroenterology. Publish Ahead of Print():, MAR 2018

DOI: 10.1097/MCG.0000000000001001
PMID: 29517711

Issn Print: 0192-0790

Publication Date: 2018/03/06


Incidence and Risk Factors of Intrauterine Transmission Among Pregnant Women With Chronic Hepatitis B Virus Infection

Songxu Peng; Zhihua Wan; Tingting Liu; Huiping Zhu; Yukai Du

- Author Information

Author Information: Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan

Abstract
Goals:

To identify the potential risk factors of hepatitis B virus (HBV) intrauterine transmission and predict the incidence of HBV intrauterine transmission among hepatitis B surface antigen–positive pregnant women with diverse viral load.
Background:

The intrauterine transmission of HBV significantly contributes to the persistence of a high number of patients infected with HBV. However, its risk factors remain unclear.
Materials and Methods:

A prospective study was performed on hepatitis B surface antigen–positive pregnant women who delivered from June 2012 to December 2016 at Wuhan Medical Care Center for Women and Children, Wuhan, China.
Results:

In total, 1200 women paired with 1219 infants were enrolled. In total, 11 (0.9%) infants were identified with intrauterine transmission. We observed that all infants with intrauterine transmission were born to hepatitis B e antigen–positive mothers who had serum HBV DNA levels >7 log10 copies/mL. Our study suggested that the HBV DNA levels (for each log10 copies/mL increase, odds ratio=5.43; 95% confidence interval, 1.31-22.43; P=0.019) had independent effects on HBV intrauterine transmission in a multivariate logistic regression model. Moreover, cesarean section (odds ratio=0.18; 95% confidence interval, 0.04-0.74; P=0.018) was associated with a reduced risk of HBV intrauterine transmission. The predictive rates of intrauterine transmission were 0.06%, 0.50%, 2.81%, 8.89% in infants with maternal HBV DNA levels of 10**5, 10**6, 10**7, 10**8 copies/mL, respectively.
Conclusions:

Our data confirmed that increasing maternal viral load has the ability to predict intrauterine HBV transmission. Vaginal delivery increased risk of HBV transmission in infants compared with cesarean section. Further studies are warranted to clarify the possible mechanism underlying these associations.

StephenW

临床消化病杂志。发布在Print（）之前：，2018年3月

DOI：10.1097 / MCG.0000000000001001
PMID：29517711

Issn打印：0192-0790

出版日期：2018/03/06


慢性乙型肝炎病毒感染孕妇宫内传播的发病率及危险因素分析

宋旭鹏;王志华;刘婷婷;朱慧萍; Yukai Du

- 作者信息

作者信息：华中科技大学同济医学院公共卫生学院妇幼保健系，武汉

抽象
目标：

探讨乙型肝炎病毒（HBV）宫内传播的潜在危险因素，并预测不同病毒载量的乙型肝炎表面抗原阳性孕妇HBV宫内传播的发生率。
背景：

HBV的宫内传播显着促成了大量HBV感染患者的持续存在。但是，其风险因素仍不清楚。
材料和方法：

对2012年6月至2016年12月在武汉武汉妇女儿童医疗中心交付的乙型肝炎表面抗原阳性孕妇进行了前瞻性研究。
结果：

总共有1200名配对1219名婴儿的女性参加。总共有11名（0.9％）婴儿被确认为宫内传播。我们观察到，所有具有宫内传播的婴儿都是由乙型肝炎e抗原阳性母亲所生，他们的血清HBV DNA水平> 7log10 copies / mL。我们的研究表明，在多因素logistic回归模型中，HBV DNA水平（每增加log10 copies / mL，比值比= 5.43; 95％置信区间，1.31-22.43; P = 0.019）对HBV宫内传播有独立影响。此外，剖宫产（比值比= 0.18; 95％置信区间，0.04-0.74; P = 0.018）与HBV宫内传播风险降低有关。母亲HBV DNA水平分别为10 ** 5,10 ** 6,10 ** 7,10 ** 8拷贝/ mL的婴儿的宫内传播预测率分别为0.06％，0.50％，2.81％，8.89％ 。
结论：

我们的数据证实，增加母体病毒载量有能力预测宫内HBV传播。与剖宫产相比，阴道分娩增加了婴儿HBV传播的风险。需要进一步的研究来澄清这些关联的可能机制。

Hepbest

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