Study On The Related Risk Factors Of Mother-to-child Transmission Of Hepatitis B Virus

【Objective】In order to prevent and control mother-to-child transmission， we do research on the prevalence of HBV in our city and probing the current situation of mother-to-child transmission and its related risk factors.【Methods】 This study included360HBsAg carrier mothers without symptoms and their360children were finally recruited in the obstetrical department of our hospital，(the total number of delivery is3008，409of them were HBsAg positive， the positive rate is13.6%). According to the application of HBIG in late pregnancy (injecting200unit of HBIG in28th，32th，36th)， we classified160cases of HBeAg positive mothers into two groups， one is injected group(40cases)，the other is non-injected group(120cases). In order to figure out whether HBIG affect HBV infection in newborn or not， we chose30cases of non-injected newborns of HBsAg positive mothers at random in2011because of short of HBIG to compare with the newborns (all of them were injected HBIG within24hours after birth)of HBsAg positive mothers in2012. Serum samples were taken from those HBsAg carrier mothers before delivery to test markers of hepatitis B， Hepatitis B virus deoxyribonucleic acid and Alanine transaminase. All the children would detect HBsAg after six months. A single lot of enzyme-linked immunosorbent assay (ELISA) reagents was used for the initial testing for HBsAg， HBeAg. All the specimens were quantified for HBV DNA by using diagnostic kit (PCR-Fluorescent probing).and with the method of rate to test Alanine transaminase.【Result】:(1) analysis of HBV carrier rate and current situation of mother-to-child transmission in our city in2012:3，008cases of pregnant women had been recruited in our hospital， of which a total of409cases is HBsAg-positive， the positive rate is13.60%；360cases of HBsAg positive mothers who met with the criteria give birth to360infants， after6months follow-up，21infants (5.83%) were found HBsAg positive (all the results of HBsAg as follow were detected after the infants were7-12months year old).(2) analysis of the risk factors of mother-to-child transmission of HBV:1.Mothers were HBV DNA-positive HBsAg positive rate of infants in HBV DNA>106copies/ml mothers group was26.67%(16/60)，comparing with HBV DNA <103copies/ml group and103-106copies/ml group， the difference was significant (p <0.05)；2.Mothers were HBeAg-positive HBsAg-positive rate of infants who were born by HBeAg-positive mothers is higher than HBeAg-negative group， the difference was significant(p <0.05)；3.HBeAg-positive mothers who were injected HBIG in late pregnancy HBsAg positive rate of infants of injected HBIG pregnant women group and infants of non-injected pregnant women group were no significant difference (p>0.05)；4.Non-injected HBIG newborns HBsAg positive rate of non-injected HBIG newborns group was significantly higher than the injected group(p<0.05).；5.Delivery method HBsAg positive rate of infants in cesarean group and eutocia group was no significant difference (p>0.05)；the same results were found considering the risk factor of mothers with HBeAg-positive；6.Feeding method HBsAg positive rate of infants in breastfeeding group was slightly lower than artificial feeding infants group， but there was no significant difference between them (X2=2.42， p>0.05)). the same results were found considering the risk factor of mothers with HBeAg-positive；【Conclusions】(1) HBV DNA>106copies/ml can be considered as the risk factor of mother-to-child transmission of hepatitis B virus；(2) HBeAg-positive is another risk factor of mother-to-child transmission of hepatitis B virus； (3) HBIG injections in late pregnancy doesn’t help reduce mother-to-child transmission of hepatitis B virus；(4) feeding and delivery method does not impact mother-to-child transmission of hepatitis B virus；(5) with the active and passive immunization to newborns of HBV carrier mothers， the protection rate reach more than94%.