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目的评价青海省孕产妇产前乙型肝炎(乙肝)病毒(HBV)标志物筛查及母婴传播阻断开展情况。方法在全省城市、农村和牧区各选择2个县(区)对14家医院的孕妇HBV标志物筛查和乙肝母婴传播阻断工作开展调查和分析,对首剂乙肝疫苗(HepB1)的未及时接种原因进行分析。结果共调查孕妇9 915名,HBV筛查率为97.75%,HBV表面抗原(HBsAg)阳性率为3.56%;9 848名住院分娩新生儿HepB1及时接种率为96.50%(9 503/9 848);345名HBsAg阳性母亲新生儿HepB1与乙肝免疫球蛋白(HBIG)联合接种率为98.55%(340/345)。上述各指标在城市、农村、牧区之间均无显著性差异。在416名未及时接种HepB1儿童中,56.97%为早产/出生低体重,30.77%为新生儿窒息,7.69%为新生儿黄疸,4.57%为家长拒绝接种。结论青海省孕产妇产前HBV标志物筛查和母婴传播阻断工作能够有效开展。需加强农村和牧区的措施落实,对医护人员需加强培训指导,合理掌握HepB禁忌证,加强早产儿/低体重儿HepB1接种。
Objective To evaluate the screening of maternal prenatal hepatitis B virus (HBV) markers and the prevention of maternal and neonatal transmission in Qinghai. Methods The screening of HBV markers in pregnant women and the blockage of mother-to-child transmission of hepatitis B in 14 hospitals in 2 cities (districts) in cities, rural areas and pastoral areas of the province were investigated and analyzed. The effects of the first dose of hepatitis B vaccine (HepB1) Not timely analysis of the causes of inoculation. Results A total of 9 915 pregnant women were investigated. The screening rate of HBV was 97.75% and the positive rate of HBsAg was 3.56%. The timely vaccination rate of 9 848 neonates was 96.50% (9 503/9 848). The combined immunization rate of HepB1 and HBIG in 345 HBsAg positive mothers was 98.55% (340/345). The above indicators in urban, rural, pastoral no significant difference between. Of the 416 children who did not receive HepB1 in time, 56.97% were premature / low birth weight, 30.77% were neonatal asphyxia, 7.69% were neonatal jaundice and 4.57% were rejected by their parents. Conclusion Prenatal screening of HBV markers and maternal-fetal transmission in pregnant women in Qinghai Province can be carried out effectively. It is necessary to strengthen the implementation of measures in rural areas and pastoral areas, strengthen training and guidance for health care workers, properly control HepB contraindications and strengthen vaccination of HepB1 in preterm children and low birth weight infants.