Effects And Influencing Factors Of Mother-to-child Block Of Hepatitis B In Chaoyang District Of Beijing

Objective:To evaluate the effect of mother-to-child block of hepatitis B in Chaoyang District of Beijing,and to explore the influencing factors of the failure of mother-to-child block of hepatitis B and provide solid data support for prevention and control of hepatitis B through mother-to-child transmission.Methods:(1)By means of descriptive epidemiological study,pregnant women and their infants who gave birth in hospitals in Beijing from 2008 to 2015 and blocked mother and child hepatitis B in Chaoyang District of Beijing were taken as the subjects of study.All these infants were followed up for the effects of mother-to-child blocking of hepatitis B at 7~18 months old after immunization.Blood samples were collected to test HBsAg,anti-HBs and the geometric mean titer of antibody.(2)By means of analytic Epidemiological study,to explore the influencing factors of the failure of mother-to-child blocking of hepatitis B,infants with HBsAg positive were selected as the case group and infants with negative HBsAg were selected as the control group from the follow-up study subjects.Results:(1)A total of 2893 mothers and 2933 infants were included in the monitoring of mother-to-child blocking effect of hepatitis B.Positive rate of HBsAg and anti-HBs in infants Vaccinated with hepatitis B immunoglobulin(Hepatitis B immunoglobulin,HBIG)was 1.6%and 87.0%.The level of anti-HBs GMT in infants Vaccinated with HBIG was 549.54mIU/ml.The positive rate of HBsAg and anti-HBs in infants without HBIG vaccination was 0.8%and 86.5%.The level of anti-HBs GMT in infants without HBIG vaccination was 891.25mIU/ml.There was no significant difference between the two groups in the positive rate of HBsAg and anti-HBs(c~2=0.988,P=0.428;c~2=0.050,P=0.824),however,there was significant difference in anti-HBs GMT between these two groups(t=-2.487,P=0.013).(2)The positive rate of HBsAg and anti-HBs in infants with low birth weight was 1.2%and 87.8%.The level of anti-HBs GMT in infants with low birth weight was 524.81mIU/ml.The positive rate of HBsAg and anti-HBs in infants with non-low birth weight was 1.5%and 86.9%.The level of anti-HBs GMT in infants with non-low birth weight was 575.44mIU/ml.There was no significant difference between the two groups of these three indices(c~2=0.055,P=0.428;c~2=0.060,P=0.807;t=-0.234,P=0.815).(3)The positive rate of HBsAg and anti-HBs in premature infants was 0.9%and 84.8%.The level of anti-HBs GMT in premature infants was 354.81mIU/ml.The positive rate of HBsAg and anti-HBs in non-premature infants was 1.6%and87.0%.The level of anti-HBs GMT in non-premature infants was 588.84mIU/ml.There was no significant difference between the two groups of these three indices(c~2=0.317,P=0.428;c~2=0.445,P=0.505;t=-1.694,P=0.090).(4)A total of 225 mothers and infants were included in the case-control of the failure of mother-to-child blocking of hepatitis B,of which 45 cases and 180controls.Single factor analysis:mother’s HBeAg,HBV DNA,HBV DNA,and anti-viral drugs during pregnancy,the way of delivery is the influence factor of mother-to-child blocking failure of infant hepatitis B,the mother’s ALT value,the status of HBIG during pregnancy,the premonitory abortion during pregnancy,and the pre-term birth in pregnancy,The feeding method is not the influencing factor of the failure of the mother-to-child blocking of the baby’s hepatitis B.(5)Multivariate analysis:the results of multivariate conditional Logistic regression analysis showed that the risk of failure of mother-to-child hepatitis B block,HBV DNA load group was 3.192 times higher than that in low load group(OR=3.192,95%CI:1.251~8.145,P=0.015).The risk of hepatitis B mother-infant blocking failure in high load group was 6.199 times higher than that in low load group(OR=6.199,95%CI:1.137~33.789,P≤0.035).Hepatitis B in infants who take antiviral drugs during pregnancy The risk of failure of mother-to-child blocking was0.102 times higher than that of non-taking drugs(OR=0.102,95%CI:0.034~0.302,P<0.05).ALT,delivery mode and feeding mode.HBeAg is not a factor affecting the failure of mother-to-child blocking of hepatitis B.Conclusion:(1)Whether or not to vaccinate HBIG did not affect the positive rate of HBsAg and anti-HBs,but affect anti-HBs GMT,vaccination with HBIG reduces anti-HBs GMT in infants.(2)Low birth weight and premature delivery did not affect the positive rate of HBsAg and anti-HBs and the level of anti-HBs GMT in infants.(3)Taking antiviral drugs during pregnancy can effectively reduce the failure rate of hepatitis B mother-to-child blocking.High HBV DNA load is a risk factor of failure of mother-to-child blocking of hepatitis B.Whether pregnant women were injected with HBIG,HBeAg infection status,delivery mode,and feeding mode had no effect on mother-to-child transmission of hepatitis B.