摘要
目的探讨分娩方式对乙型肝炎病毒(HBV)母婴垂直传播的影响,为HBV母婴垂直传播的阻断提供参考。方法选取2015年1-12月于医院住院分娩的乙型肝炎病毒表面抗原(HBsAg)阳性300例产妇及分娩新生儿,按照实际分娩方式不同分为阴道分娩组(194例)与剖宫产组(106例),检测孕妇及新生儿HBV标志物及血清HBV-DNA,新生儿给与乙型肝炎疫苗及乙型肝炎免疫球蛋白注射,观察新生儿出生后24h、6个月时HBV母婴垂直传播状况。结果阴道分娩组与剖宫产组产妇出生儿在出生24h内、6个月时HBsAg、HBsAb、HBVDNA阳性率比较差异无统计学意义;阴道分娩组产妇HBV-DNA>106copies/ml分娩出生儿在出生24h之内、6个月时HBsAg阳性率为54.55%、25.00%,HBsAb阳性率为6.82%、90.91%,HBV-DNA阳性率为60.23%、22.73%,剖宫产组分别为为36.54%、9.62%,5.77%、96.15%,40.38%、7.69%,阴道分娩组以上不同时段HBsAg、HBV-DNA阳性率高于剖宫产组,差异有统计学意义(P<0.05),HBsAb阳性率两组比较差异无统计学意义。结论 HBV-DNA较低时分娩方式对HBV母婴垂直传播影响不大,HBV-DNA较高时阴道分娩更容易发生HBV母婴垂直传播,建议HBV-DNA高水平时选择剖宫产分娩。
OBJECTIVE To investigate the effect of delivery mode on hepatitis B virus（HBV）mother-to-child vertical transmission,so as to provide reference for control of HBV vertical transmission form mother to child.METHODS A total of 300 pregnant women with positive hepatitis B surface antigens（HBsAg）and their alive newborns delivered in our hospital from Jan.to Dec.of 2015 were selected,and the woman were divided into two groups as their actual delivery ways,including vaginal delivery group（194cases）and cesarean section group（106cases）.The serum HBV markers and HBV-DNA levels were detected from pregnant women and newborn,and newborns given injection Hepatitis B vaccine and Hepatitis B hyper-immune globulin,observing the mother-tochild vertical transmission within 24 hand 6months after delivery.RESULTS The positive rate of HBsA,HBsAb and HBV-DNA in newborn babies after delivery 24 hand 6months,had no significant difference between the two groups;when mother from vaginal delivery group with HBV-DNA106copies/ml,the positive rates of HBsAg in babies after delivery 24 hand 6 months were 54.55% and 25.00%,positive rates of HBsAb were 6.82% and90.91%,and positive rates of HBV-DNA were 60.23% and 22.73%,and for cesarean section group were36.54% and 9.62%,5.77% and 96.15%,40.38% and 7.69%,respectively.The vaginal delivery group had higher HBsAg and HBV-DNA positive rates than the cesarean section group in different times（P〈0.05）,and HBsAb positive rates were no significant difference between the two groups.CONCLUSION When HBV-DNA at low level,delivery way has no obvious effect to mother-to-child HBV vertical transmission;when HBV-DNA at high level,vaginal delivery are more likely to have mother-to-child HBV vertical transmission,suggesting to take cesarean section delivery when HBV DNA is high.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第19期4506-4508,共3页
Chinese Journal of Nosocomiology
基金
广西医疗卫生适宜技术研究与开发基金资助项目(S201405-02)
关键词
乙型肝炎病毒
母婴垂直传播
分娩方式
Hepatitis B Virus
Mother-to-child vertical transmission
Delivery Mode
