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目的:探讨母亲孕期乙肝表面抗原(HBsAg)携带对妊娠结局和其子女远期生长的影响。方法:回顾性分析2002~2004年江苏地区380例HBsAg阳性和428例HBsAg阴性单胎妊娠孕妇的新生儿结局;比较两组新生儿出生体重和身长,以及早产、死胎/死产等不良妊娠结局。并于2009年10月~2010年3月随访这些儿童,检查其生长发育情况。结果:HBsAg阳性孕妇分娩的新生儿出生体重和身长分别为(3 436.1±388.1)g和(49.8±2.4)cm,与HBsAg阴性孕妇分娩的新生儿比较[(34.66±435.2)g和(49.9±2.4)cm],差异无统计学意义(P均>0.05)。HBsAg阳性组早产率(2.9%)略高于阴性组(1.4%),但差异无统计学意义(P=0.140)。两组死胎或死产(0.5%vs.0.2%)、新生儿死亡(0.5%vs.0.5%)和先天性畸形(0.8%vs.1.4%)的发生率相近。Logistic回归证实母孕期HBsAg携带与不良妊娠结局无关(P均>0.05)。随访时,271例(71.3%)HBsAg阳性孕妇分娩的儿童与297例(69.4%)HBsAg阴性孕妇所分娩的儿童的体重和身高比较,差异均无统计学差异(P>0.05)。HBsAg阳性孕妇分娩的儿童出现1例(0.26%)脑瘫,而HBsAg阴性孕妇分娩的儿童出现4例(0.93%)异常。结论:母亲孕期HBsAg携带不增加不良妊娠结局风险,且不影响其子女远期生长。产前检查时无须特别对HBsAg阳性孕妇进行不良妊娠结局风险评估。
Objective: To investigate the effect of mother’s HBsAg carrier on the outcome of pregnancy and the long-term growth of her children. Methods: The neonatal outcomes of 380 HBsAg-positive and 428 HBsAg-negative singleton pregnancies in Jiangsu province from 2002 to 2004 were analyzed retrospectively. The birth weight, body length, and prenatal and stillbirth / stillbirth adverse pregnancy outcomes were compared between the two groups . And in October 2009 ~ March 2010 follow-up of these children, check their growth and development. Results: The birth weight and length of newborn infants born to HBsAg positive pregnant women were (3 436.1 ± 388.1) g and (49.8 ± 2.4) cm, respectively, compared with those born to HBsAg negative pregnant women [(34.66 ± 435.2) g and (49.9 ± 2.4) cm], the difference was not statistically significant (P all> 0.05). The preterm birth rate (2.9%) in HBsAg positive group was slightly higher than that in negative group (1.4%), but the difference was not statistically significant (P = 0.140). The incidence of stillbirth or stillbirth (0.5% vs.0.2%), neonatal death (0.5% vs.0.5%) and congenital malformation (0.8% vs.1.4%) were similar in both groups. Logistic regression confirmed that HBsAg infection during pregnancy was not associated with adverse pregnancy outcomes (all P> 0.05). At follow-up, there was no significant difference in body weight and height between 271 (71.3%) HBsAg-positive pregnant women and 297 (69.4%) HBsAg-negative pregnant women. One child (0.26%) with childbirth in HBsAg-positive pregnant women showed cerebral palsy, while 4 children (0.93%) with childbirth in HBsAg-negative pregnant women showed abnormalities. Conclusion: Maternal HBsAg during pregnancy does not increase the risk of adverse pregnancy outcomes, and does not affect the long-term growth of their children. There is no need to specifically assess the risk of adverse pregnancy outcomes for HBsAg-positive pregnant women at prenatal screening.