| Objective: To investigate the current situation of mother-to-child transmission of hepatitis B in Bao ’an District,Shenzhen,and to explore the influencing factors of mother-to-child transmission of hepatitis B,so as to provide suggestions and evidence support for the elimination of mother-to-child transmission in China.Methods: Epidemiological methods such as current situation study were used to describe the blocking effect of mother-to-child transmission of hepatitis B in Bao’an District.Retrospective nested case-control study and unconditional logistic regression model were used to explore the influencing factors of blocking mother-to-child transmission of hepatitis B;Obtain relevant indicators through questionnaire survey and laboratory measurement.Results :(1)A total of 3349 mother-child pairs were included in this study,with an average age of 29.5±4.30.1848 male infants(55.2%)and 1501 female infants(44.8%);Low birth weight 97(2.9%);130 preterm births(3.9%);There were 435 patients(13.0%)in the anti-HBS GMT non-response group,328 patients(9.8%)in the low response group,1193 patients(35.6%)in the normal response group,and 1393 patients(41.6%)in the high response group.(2)From January 2018 to June 2019,a total of 45 infants born to pregnant women with positive hepatitis B were positive for HBs Ag,which means the failure rate of mother-to-child occlusion was 1.3%(45/3349).The infant antibody protection rate increased from 93.0% in 2018 to 96.2% in 2019.(3)After the birth of infants,the earlier the combined immunization time,the higher the success rate of mother-to-child transmission blocking of hepatitis B,and the lower the risk of infection of infants(Chi-square trend test,P < 0.05).(4)The risk of HBV infection in infants born to pregnant women with abnormal ALT index was 4.415 times that of normal pregnant women(OR = 4.415,95% CI: 0.878–13.278,P = 0.061).The difference was not statistically significant.Infants born to HBe Ag-positive mothers were 2.943 times more likely to develop hepatitis B than infants born to HBe Ag-negative mothers(OR = 2.943,95% CI: 1.295~6.688,P = 0.08);The risk of HBV infection in infants born to HBV DNA-positive pregnant women was 4.000 times that of HBV-negative pregnant women(OR=4.000,95% CI: 1.501–10.658,P = 0.003),and the risk of HBV infection in infants born to high-load pregnant women was 5.874 times that of low-load pregnant women(OR = 5.874,95% CI: 1.999–17.258,P <0.001).(5)The risk of mother-to-child transmission of hepatitis B was 0.179 times higher in pregnant women who took antiviral drugs than in pregnant women who did not take antiviral drugs(OR = 0.179,95% CI: 0.067–0.475,P < 0.001).The risk of mother-to-child transmission of hepatitis B in pregnant women with threatened abortion was 4.889 times that in non-pregnant women(OR = 4.889,95% CI: 0.635–37.638,P = 0.168).The risk of mother-to-child transmission of hepatitis B in pregnant women with threatened premature delivery was 4.000 times higher than that in pregnant women without threatened premature delivery(OR = 4.000,95% CI: 1.501–10.658,P = 0.003;The risk of mother-to-child transmission of hepatitis B by cesarean section was 0.567 times that by natural labor(OR = 0.567,95% CI: 0.294–1.095,P = 0.089).The risk of mother-to-child transmission of hepatitis B was 1.116 times higher with artificial feeding than with breastfeeding(OR = 1.116,95% CI: 0.478–2.608,P = 0.799).(6)Results of unconditional Logistic regression model showed that the risk of mother-to-child transmission of hepatitis B of infants in pregnant women who did not take antiviral drugs during pregnancy was 9.523 times that of infants who took drugs(OR = 9.523,95% CI: 1.523–15.303,P = 0.048).The risk of mother-to-child transmission of hepatitis B was 4.762 times that of 0-6 hours(OR = 4.762,95% CI: 1.002–9.235,P = 0.045).The risk of mother-to-child transmission of hepatitis B in late pregnancy with threatened premature birth was 2.015 times that of none(OR =2.015,95% CI: 1.012–9.665,P = 0.045).The risk of mother-to-child transmission of HBV DNA-positive hepatitis B was 3.112 times negative(OR = 3.112,95% CI: 1.152–10.235,P = 0.045).When 1 × 106 IU/m L < hepatitis B viral load < 1 × 108 IU/m L,the risk of mother-to-child transmission of hepatitis B was 3.187 times that in the hepatitis B viral load < 1 × 106 IU/m L group(OR = 3.187,95% CI: 1.245–8.165,P = 0.020).Mother-to-child transmission of hepatitis B in pregnant women with hepatitis B viral load ≥1×108 IU/ml was 6.200 times that in the group with HBV DNA load < 1 × 106 IU/m L(OR=6.200,95% CI: 1.358–33.689,P = 0.033).Conclusion: 1.The effect of mother-to-child hepatitis B occlusion in Bao ’an District of Shenzhen is good,and the success rate of occlusion is higher than that in other areas of the world.The standardized management experience is worth popularizing.2.Combined immunization should be carried out as soon as possible after birth.The earlier the intervention time is,the better the effect of mother-to-child blocking of hepatitis B will be.3.Antiviral drugs taken by pregnant women with positive hepatitis B during pregnancy can significantly reduce the mother-to-child transmission rate of hepatitis B.High HBV DNA load in pregnant women is an important factor of mother-to-child transmission of hepatitis B.There was no correlation between delivery mode and feeding mode and the blocking effect of mother-to-child transmission of HBV. |
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