感染丙型肝炎病毒的孕妇及其新生儿随访观察

目的了解丙型肝炎病毒(HCV)母婴垂直传播情况及HCV感染后对新生儿体格发育的影响。方法用ELISA法对1023名孕妇静脉血做抗HCV检测，阳性者对其新生儿脐带血做抗HCV检测。阳性者(包括产妇及其新生儿)进一步做HCVRNA检测；对抗HCV阳性新生儿做10～12个月随访，观察HCV感染指标及新生儿喂养、患病、生长发育情况。结果产妇HCV感染率为2.74％(28/1023)；抗HCV阳性产妇中HCVRNA检出率为75％(21/28)；抗HCV阳性产妇的新生儿脐血中抗HCV检出率为46.43％(13/28)，其中检出HCVRNA阳性5例。对抗HCV阳性新生儿1年随访，抗HCV阴转率为69.23％(9/13)，实验组新生儿母乳喂养率57％明显低于对照组85％，实验组儿童人均患病1.25次，而对照组儿童为0.5次，有非常显著性差异，身长、体重指标明显落后于对照组。结论母婴间存在着HCV的垂直传播；HCVRNA的存在不但增加了母婴垂直传播的比率，而且延缓了抗HCV的阴转；HCV的感染非常明显地影响了新生儿的体格发育。

The follow up of maternal - fetal transmission of hepatitis C virus

Objective To investigate mother to child transmission of hepatitis C virus (HCV) and the influence of HCV infection on the physical development of newborns.Methods Blood HCV antibodies were detected by ELISA in 1023 pregnant women.HCV RNA was detected in both HCV infected mothers and infants,and infants have been followed up for 10 to 12 months,during which the feeding,disease suffered and physical growth were observed.Results The incidence of HCV infection was 2 74%(28/1023) in pregnant women.HCV RNA was positive in 75%(21/28) of mothers infected by HCV.HCV was positive in 46 43% of newborns,of which 5 were HCV RNA positive.Infants with HCV antibodies were followed up for one year,69 23%(9/13) of anti-HCV changed to negative.The body weight and height in anti-HCV positive group were significantly lower than those in control group.Conclusion Mother to child transmission of HCV exists during pregnancy.HCV RNA not only increases the risk of maternal-fetal transmission,but also delays the excretion of HCV antibodies.HCV infection greatly retards the physical growth of newborns.