Follow-up study on hepatitis B virus mother-to-child transmission in 1355 HBsAg-positive pregnant women / 中华传染病杂志

ABSTRACT

Objective To investigate hepatitis B virus (HBV) mother-to-child transmission rate in hepatitis B virus surface antigen (HBsAg)-positive pregnant women.MethodsA total of 1355 HBsAg-positive pregnant women and their 1360 newborns (included 5 twins)were collected prospectively.All newborns received hepatitis B immunoglobulin (HBIG) 200 U intramuscularly within 6 hours of birth as early as possible,and were administered with routine 10 μg recombinant hepatitis B vaccine (at 0,1,6 months of birth).The venous blood HBV markers and HBV DNA levels were detected in all newborns at 0,7,12 months of age.The measurement data were analyzed by t test.Qualitative data were analyzed by chi square test,rank sum test or Fisher exact test.Results The intrauterine HBV infection rate of 1360 infants were 1.54％ (21/1360) during 12 months of follow-up.The rate of intrauterine infection in HBeAg positive mothers was significant higher than that of HBeAg negative mothers (4.44％ vs 0,χ2 =35.99; P＜0.05); the rate of intrauterine infection in HBV DNA positive mothers was significant higher than that of HBV DNA negativemothers (3.13％ vs 0,χ2 =21.84; P＜0.05).When maternal serum HBV DNA≥1 × 107 IU/mL,the rate of intrauterine infection was 6.01 ％,which was significantly higher than that of maternal serum HBV DNA＜ 1 × 107 IU/mL (χ2 =39.43,P＜0.05).ConclusionsAfter strict combined active-passive immunization,the rate of HBV intrauterine infection is 1.54％.When mothers are HBeAg positive or with high level of HBV DNA,the rate of HBV intrauterine infection increases significantly.Intrauterine infection is the main cause of failure in immunoblockade of HBV mother-to-child transmission.