羊膜穿刺术后母婴传播乙型肝炎病毒：一项回顾性匹配队列

StephenW

Prenat Diagn. 2019 Mar 27. doi: 10.1002/pd.5452. [Epub ahead of print]
Mother-to-child transmission of hepatitis B virus after amniocentesis: a retrospective matched-cohort study.
Han Z1, Zhang Y1, Bai X1, Yin Y1, Xu C1, Hou H1.
Author information

1
    Department of Obstetrics and Gynecology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, 510630, China.

Abstract
OBJECTIVE:

To determine whether amniocentesis increases the risk of mother-to-child transmission (MTCT) of hepatitis B virus (HBV) and evaluate risk factors for MTCT.
METHODS:

143 hepatitis B surface antigen (HBsAg)-positive women with amniocentesis were enrolled into the amniocentesis group. 605 non-amniocentesis cases were matched with amniocentesis cases based on maternal viral loads, antiviral therapy regimens, and delivery dates. MTCT of HBV was defined as HBsAg and/or DNA positivity in infants from birth to age 7-12 months.
RESULTS:

MTCT rate was significantly higher in HBsAg-positive women with amniocentesis than in those without amniocentesis (2.80% vs. 0.50%; RR, 5.64, 95% CI, 1.28-24.93). In the amniocentesis group, maternal HBV DNA ≥7.0 log10 IU/ml and hepatitis B e-antigen (HBeAg) positivity were associated with higher MTCT rates than maternal HBV DNA <7.0 log10 IU/ml (10.81% vs. 0%, P=0.004) and HBeAg negativity (8.16% vs. 0%, P=0.013), and antiviral therapy reduced MTCT rate from 14.3% to 0% (P=0.554) when maternal HBV DNA was ≥7.0 log10 IU/ml.
CONCLUSIONS:

Amniocentesis increases the risk of MTCT in women with hepatitis B, and maternal HBV DNA ≥7.0 log10 IU/ml and HBeAg positivity are risk factors for MTCT. Antiviral therapy may be effective to prevent MTCT after amniocentesis in highly viremic mothers.

This article is protected by copyright. All rights reserved.

PMID:
    30916399
DOI:
    10.1002/pd.5452

StephenW

Prenat Diagn。 2019年3月27日doi：10.1002 / pd.5452。 [印刷前的电子版]
羊膜穿刺术后母婴传播乙型肝炎病毒：一项回顾性匹配队列研究。
韩Z1，张Y1，白X1，尹Y1，徐C1，侯H1。
作者信息

1
    中山大学附属第三医院妇产科，广东广州510630

抽象
目的：

确定羊膜穿刺术是否会增加乙型肝炎病毒（HBV）母婴传播（MTCT）的风险，并评估MTCT的危险因素。
方法：

将143例乙型肝炎表面抗原（HBsAg）阳性的羊膜穿刺女性纳入羊膜穿刺术组。根据母体病毒载量，抗病毒治疗方案和分娩日期，将605例非羊膜穿刺术与羊膜穿刺术相匹配。 HBV的MTCT定义为婴儿从出生到7-12个月的HBsAg和/或DNA阳性。
结果：

羊水过滤的HBsAg阳性女性的MTCT率显着高于没有羊膜穿刺术的女性（2.80％对0.50％; RR，5.64,95％CI，1.28-24.93）。在羊膜穿刺组中，母体HBVDNA≥7.0log10IU/ ml和乙型肝炎e抗原（HBeAg）阳性与母体HBV DNA <7.0 log10 IU / ml相比具有更高的MTCT率（10.81％对0％，P = 0.004）和HBeAg阴性（8.16％对比0％，P = 0.013），并且当母体HBVDNA≥7.0log10IU/ ml时，抗病毒治疗将MTCT率从14.3％降低至0％（P = 0.554）。
结论：

羊膜穿刺术增加了乙型肝炎女性患MTCT的风险，母体HBVDNA≥7.0log10IU / ml和HBeAg阳性是MTCT的危险因素。在高病毒血症母亲的羊膜穿刺术后，抗病毒治疗可能有效预防MTCT。

本文受版权保护。版权所有。

结论：
    30916399
DOI：
    10.1002 / pd.5452