HBsAg阳性孕妇新生儿HBV宫内感染的影响因素研究

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。

Study on influence factors of HBV intrauterine infection in newborns of pregnant women with HBsAg

Objective To explore the interrelated influence factors of HBV intrauterine infection in newborns of pregnant women with HBsAg.Methods HBsAg positive pregant women,who were prenatal diagnosis and partal,and their’s newborns were as subiects.Datas of general situation of pregnant women and HBIG Jection history before delivery and HBV infection history in family and HBVM and HBVM in newborns at birth within 24h were collected.By if newborns occurred HBV intrauterine infection,379cases HBsAg-positive pregnant women are devided into two groups:36 cases of HBV intrauterine infection,343 cases of no HBV intrauterine infection.Then the relationship between the general situation of pregnant women,HBV infection history in family,the state of HBV replication,HBIG injection history,HBVM positive modes and HBV intrauterine infection in newborns were analyzed.Results Single factors analysis show:The difference of age,the state of HBV replication,HBVM positive modes of HBsAg positive pregant women between HBV intrauterine infection group and no HBV intrauterine infection group is significant(p < 0.05).But cultural levels,HBV infection history in family and HBIG injection history of HBsAg positive pregant women between the two groups isn’t significant(p > 0.05).Multiariate Logistic regression analysis display: the age(OR = 0.398,0.159-0.996) and both postitivity of HBeAg and HBV DNA(OR = 2.539,1.233-5.227) go into regression equation.Meanwhile,the analysis of relation of HBV DNA load grade of HBsAg positive pregnant women and HBV intrauterine infection show: the different is significant(χ2 = 10.983,P = 0.004 < 0.05);And the analysis of trend chi-quare test show: when HBV DNA copy number is more than 106,the rate of HBV intrauterine infection obviously rise.Conclusions: The age(> 30 years)are the protected factors of HBV intrauterine infection in HBsAg positive pregant women.But when HBsAg positive pregant women is both postitivity of HBeAg and HBV DNA,the possibility is bigger to occur HBV intrauterine infection.