HBV高病毒载量孕妇与新生儿宫内感染的相关性分析

Correlation between high HBV load of pregnant women and intrauterine infection of neonates

    摘要
  • 摘要: 目的 分析孕妇乙型肝炎病毒(HBV)感染状态与新生儿宫内感染的相关性。方法 收集2015年1月-2017年1月医院收治的HBV感染的单胎妊娠孕妇680例的临床资料,所有孕妇均取外周静脉血进行乙肝两对半、HBV-DNA定量测定,待分娩后取新生儿脐带血行HBV-DNA定量测定,按HBV感染情况进行分组,其中乙肝表面抗原(HBsAg)、乙型肝炎E抗原(HBeAg)、乙型肝炎核心抗原(HBcAg)阳性者165例(A组),HBsAg、乙型肝炎E抗体(HBeAb)、HBcAb阳性者455例(B组),HBsAg、乙型肝炎核心抗体(HBcAb)阳性者53例(C组),HBsAg、HBeAg阳性者7例(D组),分析孕妇乙肝感染情况与新生儿宫内感染的关系。结果 680例携带乙肝病毒单胎妊娠孕妇共发生新生儿感染64例,感染率为9.41%,A、B、C、D四组感染率分别为14.55%、6.15%、22.64%、0,其中C组感染率最高(P＜0.05),但四组感染率差异无统计学意义;680例携带乙型肝炎病毒孕妇新生儿HBV-DNA阳性56例,阳性率为8.24%,A组阳性率为18.18%高于B组5.71%、C组1.87%、D组0(P<0.05);HBV-DNA病毒载量≥105 copies/ml孕妇的新生儿HBsAg和HBV-DNA的阳性率分别为25.74%、24.75%高于病毒载量103~105 copies/ml和＜103 copies/ml的孕妇的新生儿(P<0.05);孕妇HBV-DNA病毒载量与新生儿宫内感染发生率呈正相关(P<0.05)。结论 HBV感染孕妇新生儿宫内感染发生率较高,且HBV病毒载量越高,新生儿宫内感染风险越大。

     

    Abstract: OBJECTIVE To analyze the correlation between hepatitis B virus (HBV) infection in pregnant women and intrauterine infection of neonates. METHODS The clinical data of 680 cases of HBV infected women with single pregnancy who were admitted to the hospital from Jan. 2015 to Jan. 2017 were collected. The peripheral blood of all pregnant women were collected for hepatitis B two half-and-half and quantitative determination of HBV-DNA, and the umbilical cord blood of neonates was taken after birth for HBV-DNA quantitative determination. According to the situation of HBV infection, the subjects were grouped. Totally 165 cases with positive hepatitis B surface antigen (HBsAg), hepatitis B E antigen (HBeAg) and hepatitis B core antigen (HBcAg) were included into group A, 455 cases with positive HBsAg, hepatitis B E antibody (HBeAb) and HBcAb were included into group B, 53 cases with positive HBsAg and hepatitis B core antibody (HBcAb) were included into group C, and 7 cases with positive HBsAg and HBeAg were included into group D. The relationship between hepatitis B infection in pregnant women and intrauterine infection of neonates was analyzed. RESULTS There were 64 cases of neonatal infections in 680 cases of hepatitis B virus infected women with single pregnancy, and the infection rate was 9.41%. The infection rates in group A, group B, group C and group D were 14.55%, 6.15%, 22.64% and 0, respectively. The infection rate was the highest in group C (P＜0.05), The HBV-DNA was positive in 56 cases of neonates in 680 pregnant women with hepatitis B virus, and the positive rate was 8.24%. The positive rate in group A (18.18%) was higher than that in group B (5.71%), group C (1.87%) or group D (0) (P<0.05). The positive rates of HBsAg and HBV-DNA in neonates borne by women with HBV-DNA viral load ≥ 105 copies/ml were 25.74% and 24.75%, which were higher than those in women with viral load of 103~105 copies/ml or women with viral load < 103 copies/ml (P<0.05). There was a positive correlation between the HBV-DNA viral load of pregnant women and the incidence of intrauterine infection in neonates (P<0.05). CONCLUSION The incidence of intrauterine infection is relatively higher in neonates born by HBV infected pregnant women, and the higher the HBV viral load is, the higher the risk of neonatal intrauterine infection is.

     

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