乙型肝炎病毒宫内跨胎盘传播的影响因素研究

[目的]探讨乙型肝炎病毒(HBV)通过宫内跨胎盘传播情况及其影响因素,为预防HBV母婴传播提供依据。[方法]选择上海市宝山区154名HBsAg阳性产妇和297名HBsAg阴性产妇分别开展流行病学问卷调查,并采集母亲外周血和新生儿脐带血来检测乙肝血清学指标及HBV DNA滴度。新生儿脐带血HBsAg阳性与HBV DNA阳性者定义为HBV跨胎盘传播。[结果]HBsAg阳性产妇所生新生儿脐带血HBV阳性率为8.4%。HBsAg和HBeAg双阳性产妇的新生儿HBV阳性率高于HBsAg单阳性产妇的新生儿HBV阳性率(20.0%比3.7%,P<0.05),相对危险度(RR)为5.41。随着母亲外周血HBV DNA水平的提高,跨胎盘传播的发生率也逐步提高。[结论]HBeAg可经过胎盘屏障直接传递至脐带血,而HBsAg则受到一定程度的

Study on risk factors in trans-placental transmission of hepatitis B virus

[Objective] To study hepatitis B virus (HBV) mother-to-child transmission and the impact factors, providing the basis for preventive strategies. [Methods] A total of 154 hepatitis B surface antigen (HBsAg)-positive pregnant women and 297 HBsAg-negative pregnant women from Baoshan District Centers for Disease Control and Prevention in Shanghai were enrolled and received an epidemiological survey regarding mother-to-child transmission. Mothers' peripheral blood and newborns' cord blood were collected to be tested for HBV serological markers and HBV DNA load. HBsAg positivity and HBV DNA ≥ 10³ copies/mL in cord blood of newborns born of HBsAg-positive mothers was defined as trans-placental HBV transmission. [Results] The trans-placental transmission rate was found to be 8.4% for HBsAg-positive mothers. Trans-placental transmission rate was significantly higher among both HBsAg and HBeAg-positive women compared to those only with HBsAg-positiveness (20.0% vs. 3.7%, relative risk was 5.41, P<0.05), and increased with HBV DNA load in mothers' peripheral blood. [Conclusion] HBeAg can directly transmit through the placenta, while HBsAg is