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目的探讨HBsAg阳性孕妇新生儿发生HBV宫内感染的相关影响因素。方法以太原市第三人民医院产前检查并分娩的HBsAg阳性孕妇及其新生儿为研究对象,收集HBsAg阳性孕妇一般情况(年龄、文化程度)、分娩前HBIG注射史、家人HBV感染史、乙肝病毒标志物以及新生儿出生24小时内的乙肝病毒标志物的资料。以新生儿是否发生HBV宫内感染将379例HBsAg阳性孕妇分为两组,HBV宫内感染组36例,非HBV宫内感染组343例,进而分析HBsAg阳性孕妇的一般情况、家人感染HBV史、HBV复制状态、HBV血清标志物阳性模式及HBIG注射史与新生儿HBV宫内感染的关系。结果 (1)单因素分析显示:HBV宫内感染组与非HBV宫内感染组的HBsAg阳性孕妇年龄、HBV复制状态、HBV血清标志物阳性模式的差异均有统计学意义(P<0.05),而两组间HBsAg阳性孕妇文化程度、家人HBV感染史和HBIG注射史的差异均无统计学意义(P>0.05)。(2)多因素Logistic回归分析显示:HBsAg阳性孕妇的年龄(OR=0.398,95%CI0.159～0.996)与HBeAg和HBV DNA双阳性(OR=2.539,95%CI 1.233～5.227)被引入回归方程。同时分析HBsAg阳性孕妇HBV DNA含量分级与HBV宫内感染关系的结果显示其差异有统计学意义(χ2=10.983,P=0.004),且进行趋势卡方分析后,显示HBV DNA拷贝数在>106时,HBV宫内感染率明显上升。结论 HBsAg阳性孕妇年龄(>30岁)是HBsAg阳性孕妇HBV宫内感染的保护因素,而血清HBeAg和HBV DNA均为阳性和HBVDNA拷贝数>106时,其发生HBV宫内感染的可能性较大。
Objective To investigate the related factors of neonatal HBV intrauterine infection in HBsAg-positive pregnant women. Methods The HBsAg-positive pregnant women and their newborns who were examined and delivered during the prenatal period in the Third People’s Hospital of Taiyuan City of Taiyuan City were enrolled. The general conditions of HBsAg positive pregnant women (age and education level), the history of HBIG injection before delivery, the history of HBV infection in their families, Virus markers and information on hepatitis B virus markers within 24 hours of birth of newborns. 379 cases of HBsAg positive pregnant women were divided into two groups with HBV intrauterine infection in neonates, 36 cases of HBV intrauterine infection, 343 cases of non-HBV intrauterine infection, and then analyzed the general situation of HBsAg positive pregnant women, the family history of HBV infection , HBV replication status, HBV seroprevalence and HBIG injection history and neonatal HBV intrauterine infection. Results (1) Univariate analysis showed that there were significant differences in age, HBV replication status and HBV seroprevalence between HBV intrauterine infection group and non-HBV intrauterine infection group (P <0.05) There was no significant difference in the educational level of HBsAg positive pregnant women, the history of HBV infection and the history of HBIG in both groups (P> 0.05). (2) Multivariate Logistic regression analysis showed that the age of HBsAg positive pregnant women (OR = 0.398,95% CI0.159-0.996) and HBeAg and HBV DNA double positive (OR = 2.539,95% CI 1.233-5.227) equation. At the same time, the results of HBsAg positive pregnant women with HBV DNA grading and HBV intrauterine infection showed that the difference was statistically significant (χ2 = 10.983, P = 0.004), and trend chi-square analysis showed HBV DNA copy number> 106 When, HBV intrauterine infection was significantly increased. Conclusion The age (> 30 years) of HBsAg positive pregnant women is the protective factor of HBV intrauterine infection in HBsAg positive pregnant women, while the serum HBeAg and HBV DNA are positive and HBVDNA copy number> 106, the possibility of HBV intrauterine infection is more .