HBV宫内感染危险因素的病例对照研究

目的 探索乙型肝炎病毒(HBV)宫内感染的危险因素,为预防HBV宫内感染提供科学依据.方法 将2013年4月至2015年5月妊娠后经筛选HBsAg阳性312例孕妇作为研究对象,观察至婴儿出生后6个月,以HBsAg和(或)HBV DNA检测阳性婴儿的母亲为宫内感染病例组,其余婴儿的母亲为对照组,采用Logistic回归分析法对HBV宫内感染危险因素进行分析.采用问卷调查法收集基本资料,时间分辨免疫荧光分析法检测HBsAg,PCR方法检测HBV DNA的水平,自动生化分析仪检测ALT、AST、三酰甘油、胆固醇等肝功能指标.结果 单因素分析结果显示HBeAg、HBV DNA、羊水污染、孕期性行为与HBV宫内感染有关(P＜0.05).多因素Logistic回归结果显示:孕妇HBeAg阳性(OR=2.76,95％CI=1.19～7.94)、孕妇HBVDNA阳性(OR=9.62,95％CI=2.58～35.33)、孕期性行为(OR=1.53,95％CI=1.07～6.40)是宫内感染的危险因素.结论 孕妇HBeAg和HBV DNA阳性、孕期性行为可能是新生儿HBV宫内感染的高危因素.

A case-control study on risk factors for intrauterine HBV infection

Objective To explore the risk factors for hepatitis B virus (HBV) intrauterine infection to provide a scientific ev idence for itsprevention.Methods Three hundred and twelve pregnant women of HBsAg positive screened from April 2013 to May 2015 served as the research subjects and were followed up until 6 months after birth.The infantile mothers of HBsAg and/or HBV DNA positive were selected as the intrauterine infection case group,while other mothers served as the control group.The Logistic regression analysis was adopted to analyze the risk factors for intrauterine HBV infection.The questionnaire survey method was used to collect the basic data and time-resolved immunofluorescence assay was used to detect HBsAg.PCR was adopted to measure level of HBV DNA and automatic biochemistry analyzer was used to measure the hepatic functional parameters including ALT,AST,triglyceride and cholesterol.Results The single factor analysis results indicated that HBeAg,HBV DNA,contamination of amniotic fluid and sexual behavior during pregnancy were related to HBV intrauterine infection(P＜0.05).The multiple variate Logistic regression results showed that positive HBeAg(OR=2.76,95 ％ CI=1.19-7.94),positive HBV DNA(OR=9.62,95 ％ CI=2.58-35.33),and sexual behaviors during pregnancy (OR =1.53,95 ％ CI =1.07-6.40) were the risk factors for intrauterine HBV infection.Conclusion Pregnant women with positive HBeAg,positive HBV DNA and sexual behavior during pregnancy may be the high risk factors for neonatal intrauterine HBV infection.