Risk factors of HBV intrauterine transmission among HBsAg-positive pregnant women.
Risk factors of HBV intrauterine transmission among HBsAg-positive pregnant women.
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DOI：
10.1111/jvh.12032
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发表时间：
2013-05
影响因子：
2.5
通讯作者：
Zhang YW
中科院分区：
文献类型：
--
作者：
Guo Z;Shi XH;Feng YL;Wang B;Feng LP;Wang SP;Zhang YW
在HBsAg阳性母亲中，与乙型肝炎病毒（HBV）宫内传播相关的危险因素知之甚少。我们在中国太原进行了一项研究，包括1133名HBsAg阳性的母亲及其婴儿。101例新生儿HBsAg和/或HBV DNA阳性，宫内传播率为8.9%。孕妇月经不调（OR=4.95, 95%CI: 1.71, 14.33）和妊娠早期严重恶心（OR=1.86, 95%CI: 1.11, 3.09）与宫内传播风险增加相关，而剖宫产（OR=0.32, 95%CI: 0.20, 0.51）在调整潜在混杂因素后与风险降低相关。母体HBeAg阳性是宫内传播的独立预测因子（OR=2.56, 95%CI: 1.54, 4.27）。母体HBV DNA水平与宫内传播呈正相关。孕妇妊娠期间服用HBIG、HBV感染家族史和胎膜早破与宫内传播风险无关。本研究证实产妇HBeAg阳性是宫内传播的危险因素，剖宫产是宫内传播的保护因素。新发现与月经不规律和妊娠早期严重恶心有关，值得进一步调查。
Little is known about the risk factors associated with hepatitis B virus (HBV) intrauterine transmission among HBsAg positive mothers. We conducted a study in Taiyuan, China including 1,133 HBsAg positive mothers and their babies. A total of 101 neonates had HBsAg and/or HBV DNA positive with an intrauterine transmission rate of 8.9%. Maternal menstrual irregularity (OR=4.95, 95%CI: 1.71, 14.33) and severe nausea during the first trimester (OR=1.86, 95%CI: 1.11, 3.09) were associated with an increased risk of intrauterine transmission, while cesarean delivery (OR=0.32, 95%CI: 0.20, 0.51) was associated with a decreased risk after adjusting for potential confounders. Maternal HBeAg positive was a strong independent predictor for intrauterine transmission (OR=2.56, 95%CI: 1.54, 4.27). A positive association between maternal HBV DNA levels and intrauterine transmission was suggested. Maternal HBIG administration during pregnancy, family history of HBV infection, and premature rupture of membranes were not associated with the risk of intrauterine transmission. The study confirmed that maternal HBeAg positive was a risk factor and cesarean delivery was a protective factor for intrauterine transmission. The new findings associated with menstrual irregularity and severe nausea during the first trimester warrant further investigation.
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