Evaluation Of The Effects Of Intervention Measures To Prevent Mother-to-child Transmission Of Hepatitis B In A City Of Hebei Province

Objective:Investigate the implementation of regional measures to prevent mother-to-child transmission of hepatitis b.Obtain the occurrence of mother-to-child transmission of hepatitis b.Evaluate the effect of preventing mother-to-child transmission of hepatitis b and analyze the influencing factors.Methods:1.On April 1,2016-March 31,2017,in the study area in hospital childbirth 316 for HBsAg positive maternal and infant,consult the relevant medical record,the questionnaire survey to obtain maternal social demographic characteristics,characteristics of hepatitis b infection,the pregnancy related condition and tested for hepatitis b screening and related services,basic situation investigation infants and young children,generally at birth and hepatitis b immune globulin and hepatitis b vaccination injection,etc.2.2ml venous blood of infants and infants born to HBsAg positive pregnant women was collected on the spot for serological markers(two-and-a-half)of hepatitis b virus infection to determine the infection status.3.Through the questionnaire survey of 12 public and private medical institutions in the study area that provide services for preventing mother-to-child transmission of hepatitis b,the provision of services related to preventing mother-to-child transmission of hepatitis b is understood.Epidata 3.1 software was used to establish a database,and the questionnaire was sorted out and double-entered after examination.SPSS 23.0 and Excel were used to collate and make statistical analysis of the data.Powerusageeffectiveness or forming than describing,HBsAg positive maternal social demographic characteristics,characteristics of hepatitis b infection,the infant basic situation when the pregnancy related condition and investigation,the general condition and HBsAg positive maternal birth and infants born to accept interventions in prevention of mother-to-child transmission of hepatitis b and other information.Hepatitis b infection in infants and young children is occurring and whether the immune response as the dependent variable respectively,using the chi-square test and the multi-factor Logistic regression model analysis of infant hepatitis b infection and the influence factors of the immune response.Results:1.Investigate the implementation of regional intervention measures to prevent mother-to-child transmission of hepatitis b1.1 medical institution service provisionThis survey area of 12 in maternal health care services and child health care service of medical institutions,can provide maternal maternal hepatitis b screening tests,HBsAg positive maternal newborn first dose of hepatitis b vaccine and hepatitis b immune globulin vaccination and prevention of mother-to-child transmission of hepatitis b intervention services.Eight medical institutions can provide follow-up two doses of hepatitis b vaccination for infants born to mothers.1.2 hepatitis b screening and related testingParticipate in the survey of 316 cases of maternal during pregnancy are accepted the hepatitis b surface antigen screening,second liver two half-and-half detect and liver function test,only 64 cases(20.3%)accepted the HBV DNA tests during pregnancy.1.3 hepatitis b vaccine and hepatitis b immunoglobulin injectionAt the time of the survey,among 316 infants,the first dose of hepatitis b vaccine was 99.4%and 92.4%respectively,and the first dose of hepatitis b vaccine was 99.1%.Hepatitis b immunoglobulins injection rate and timely injection rate were 99.7%and 99.4%respectively.The percentage of all hepatitis b immunoglobulins and three doses of hepatitis b vaccination completed at the time of the survey was 92.4 per cent.2.Investigate the incidence of mother-to-child hepatitis b transmission in the region:Among the 316 infants and children in this study,the serological test of hepatitis b virus in 7 infants showed positive HBsAg.hepatitis b infection occurred,and mother-to-child transmission rate was 2.2%.Anti-hbs positive 303 cases,accounting for 95.9%of all infants.HBsAg and HBs were all negative in 6 cases,accounting for 1.9%.3.Prevention of mother-to-child transmission of hepatitis b intervention effect and influencing factors3.1 single factor analysis results3.1.1 single factor analysis results of hepatitis b infectionThis study found that maternal socio demographic factors,labor time,childbirth way,feeding way and HBIG.hepatitis b vaccine immunization and the service level of medical institutions in time between hepatitis b whether exposed infant hepatitis b infection,there were no statistically significant difference(P>0.05);There were statistically significant differences between HBeAg positive during pregnancy,birth weight of infants,and obstetric operations between infants exposed to hepatitis b and infants exposed to hepatitis b(P<0.05).3.1.2 single factor analysis results of immune responseThis study found that there was a statistically significant difference in birth weight between infants exposed to hepatitis b and infants exposed to hepatitis b(P<0.05).3.2 multi-factor analysis resultsThis study found that HBeAg positive during pregnancy was a risk factor for hepatitis b mother-to-child transmission in infants(P=0.048,OR=6.049,95%CI:1.014-36.081).Whole-course immunization of hepatitis b vaccine is a protective factor for the immune response of infants and young children(P=0.006,OR=0.076,95%CI:0.012-0.485).Conclusion:Intervention measures to prevent mother-to-child transmission of hepatitis b in the investigated area were well implemented and effective.In accordance with the prevention of mother-to-child transmission of HIV,syphilis and hepatitis b work plan after the implementation of comprehensive intervention measures to prevent mother-to-child transmission of hepatitis b,maternal pregnancy is HBeAg positive HBsAg positive maternal infant born to the risk of mother-to-child transmission of hepatitis b.Whole-course immunization with hepatitis b vaccine is a protective factor for immune response in infants and children born to HBsAg positive pregnant women.Suggestions in the future work,need to continue to consolidate the current prevention of mother-to-child transmission of hepatitis b intervention strategies,on maternal HBeAg positive people take targeted measures to further reduce mother-to-child transmission of hepatitis b.