福建省泉州市HBsAg阳性母亲新生儿免疫失败影响因素分析

目的 探讨泉州市HBsAg阳性母亲新生儿乙肝疫苗(HepB)免疫失败的影响因素,为采取有效的干预措施提供科学依据,以进一步降低新生儿乙肝病毒感染的风险.方法 采用1:2病例对照研究的方法,分别对118对HepB免疫失败和236对免疫成功的新生儿及母亲进行调查.通过SPSS 24.0软件进行x2检验和多因素Logisti...

Risk factors of immunoprophylaxis failure of infants borned by HBsAg positive mothers in Quanzhou,Fujian

Objective To research the influence factors about neonatal hepatitis B immunization failure borned by HBsAg positive mothers in Quanzhou City, and we provide effective intervention measures for reducing the risk of neonatal hepatitis B virus infection. Methods A 1∶2 case-control study was conducted. We respectively launched a questionnaire survey on 118 pairs newborns and mothers who failed to immunize with HepB and 236 pairs successfully immunized. χ² test and multivariate Logistic regression analysis were performed by SPSS 24.0 software.The exact probability method and continuous correction analysis method were used at the same time. Results The failure of neonatal immunization were related to the type and dose of hepatitis B vaccine, the mother′s HBeAg status and HBV DNA load. The risk of immunization failure of newborn vaccinated with 20 μg hepatitis B vaccine was 0.147 times compared with who vaccinated by 10 μg (OR=0.147, P<0.001). The success immunization rate was highest with 20 μg Saccharomyces cerevisiae hepatitis B vaccine, followed by 20 μg Hansenula polymorpha vaccine. The failure risk who borned by HBeAg-positive mother was 4.701 times compared to HBeAg-negative (OR=4.701, P<0.01). The failure risk whose mother with HBV DNA positive was 21.410 times versus those borned by negative mothers (OR=21.410, P<0.01). As the mother′s HBV DNA viral load increased, the risk of neonatal immunization failure was higher（χ²_trend=108.922, P<0.001）. Conclusions Pregnant women with HBeAg-positive and high HBV replication level was the major risk population of HBV mother-to-infant transmission. It was recommended that pregnant women with high HBV DNA viral load should be treated with antiviral therapy, and their newborns need to be vaccinated with 20 μg hepatitis B vaccine.