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目的探讨接种重组乙型肝炎(乙肝)疫苗(HepB)(酵母)阻断乙肝病毒(HBV)母婴传播的影响因素。方法在北京市、甘肃省和浙江省宁波市选择1997～2005年孕期或住院分娩时检测乙肝病毒表面抗原(HBsAg)阳性的母亲及其儿童,进行问卷调查和采集血清标本,用固相放射免疫法检测HBV血清学标志物,分析儿童HBsAg的影响因素,在单因素的基础上进行多因素非条件Logistic回归分析,探索接种重组HepB(酵母)阻断HBV母婴传播的影响因素。结果共调查719名儿童,HBsAg阳性率为10.01%。HepB接种剂量、母亲HBV感染状况和母乳喂养是接种重组HepB(酵母)阻断HBV母婴传播的主要影响因素,而分娩方式、母亲孕期是否联合免疫乙肝免疫球蛋白(HBIG)等,对接种重组HepB(酵母)阻断HBV母婴传播不产生影响。结论筛查母亲HBV感染状态、对HBsAg阳性母亲的新生儿联合免疫10μg×3重组HepB(酵母)对提高阻断HBV母婴传播的效果具有重要意义。剖宫产、母亲孕期接种HBIG不能提高阻断HBV母婴传播的效果。母乳喂养对阻断HBV母婴传播效果的影响还需进一步研究。
Objective To investigate the factors influencing the mother-to-infant transmission of hepatitis B virus (HBV) vaccinated with recombinant Hepatitis B vaccine (HepB) (yeast). Methods Selected mothers and their children with positive HBsAg positives during 1997-2005 pregnancy or hospital delivery in Beijing, Gansu and Ningbo, Zhejiang Province were investigated by questionnaire and serum samples were collected. HBV serology markers were detected to analyze the influencing factors of HBsAg in children. Based on the single factor, the multivariate non-conditional logistic regression analysis was conducted to explore the factors influencing the blocking of mother-to-child transmission of hepatitis B virus (HBV). Results A total of 719 children were investigated. The positive rate of HBsAg was 10.01%. HepB inoculation dose, maternal HBV infection status and breastfeeding were the main factors influencing the transmission of recombinant HepB (yeast) to prevent the transmission of HBV from mother to child. However, the mode of delivery and whether the mother combined immunization with hepatitis B immunoglobulin (HBIG) HepB (yeast) block HBV mother-to-child transmission has no effect. Conclusion Screening of mother’s HBV infection status is of great significance for the joint immunization of 10μg × 3 recombinant HepB (yeast) with newborn infants of HBsAg-positive mothers to improve the effect of blocking the mother-to-child transmission of HBV. Cesarean section, mothers vaccination HBIG during pregnancy can not improve the effect of blocking the mother-to-child transmission of HBV. The effect of breastfeeding on blocking the effect of mother-to-child transmission of HBV needs further study.