Analysis Of The Status Of Hbv Infection Among Pregnant Women And Evaluation Of Effect Of Preventing Mother-to-Child Transmission Of Hbv In Shenzhen City

BackgroundHepatitis B(HB)is one of the major global public health problems.It is reported that there is about 2 billion people infected with Hepatitis B virus(HBV)worldwide,while 17.5% of them was chronic hepatitis B carriers.It is at least 50% of the chronic hepatitis B carriers were infected by intrauterine infection or in their early childhood.If both hepatitis B surface antigen(HBsAg)and e antigen(HBeAg)were positive in mothers,the probability infected with HBV of their children was 90%.The younger the age,the higher the probability infected with HBV.So it is so important that preventing mother-to-child transmission(MTCT)of HBV in our country.At present,there are two major measures to prevent MTCT of HB,screening for HBsAg in pregnant women and newborn immunization.Hepatitis B immune globulin(HBIG)and HB vaccine were administrated to neonates born to HBsAg-positive mothers.It was started in the year 2002 to provide free HB vaccines to all neonates that were born in Shenzhen City,while screening for HBsAg in pregnant women was started in the year 2010.Nearly 0.2 million of pregnant women was screened.HBIG and HB vaccine would be inoculated to neonates in different body sites if their mothers were HBsAg-positive.There were no researches to analyze the status of HBV infection in pregnant women and to evaluate the effect of measures to prevent MTCT of HB.ObjectiveTo understand the status of HBV infection in pregnant women,to compare HBV infection status between local and migrant pregnant women and to evaluate the effect of measures of preventing MTCT of HB,providing scientific evidences for intervention of MTCT of HB in Shenzhen City.Subjects and methodsOur subjects were pregnant women who went to midwifery agencies for their first examination from 2011 to 2015 and neonates born in 2015 whose mothers were HBsAg-positive.Second liver two half-and-half were detected in pregnant women with their informed consent,results of which were input in the Maternal Child Information System(MCIS)by first attending physician.Children came from mothers who were HBsAg-positive were urged to detect second liver two half-and-half by doctors in community health service center after the hepatitis B vaccination program was completed.Results of detection were also recorded in the MCIS.The information of a certain number of children born to women who were positive of HBsAg was used to assess the effect of preventing of MTCT.It could be obtained from MCIS that the serological test results of hepatitis B and general demographic information of pregnant women from the year 2011 to 2015,and the information of children born to HBsAg-positive mothers.The statistical package SPSS 21.0 was used for all analyses performed herein.Chi-square test and Fisher's exact test were used to compare differences between variables.Binary logistic regression was used to adjust for the confounding factors.For all analyses,statistical evaluations were made assuming a two-sided test with a significance level of value P<0.05.ResultsThere are 732783 cases of pregnant women were detected actually,with 635554 migrant women(86.73%)and 97229 local women(13.27%),from 2011 to 2015 in Shenzhen City.Prevalence of HBsAg,antibody to hepatitis B surface antigen(anti-HBs),hepatitis B virus e antigen(HBeAg),antibody to hepatitis B e antigen(anti-HBe)and antibody to hepatitis B core antigen(anti-HBc)in pregnant women were 8.66%,49.27%,3.10%,49.27%,22.27%,respectively.The proportion of pregnant women who are both positive of HBsAg and HBeAg was 30.25%.Positive rate of anti-HBs in pregnant women who are HBsAg-positive was 53.51%.Positive rate of HBsAg in migrant pregnant women(8.83%)was higher than that(7.62%)in the locals,while positive rate of anti-HBs(46.03%)was lower than that(70.41%)in the locals.There was 6376 children born to mothers who were positive of HBsAg were detected second liver two half-and-half in 2015.Rate of timely birth dose of HB vaccine was 97.09%.The migrants and multiple pregnancies were risk factors to positive rate of HBsAg while the high degree of education was a kind of protective factor.After children whose mothers were HBsAg-positive completed immunization program of HB,HBsAg and anti-HBs were detected in serum of the newborns aged 9 to 18 months and positive rates of the above two were 0.87%,95.65%,respectively.Conclusion 1.Positive rate of HBsAg in pregnant women in Shenzhen City(8.66%)and the proportion of pregnant women who were both positive of HBsAg and HBeAg were higher,so it was significant to public health that preventing MTCT.2.Infection status of HBV in migrant pregnant women was more serious than that in the locals,so it must be highly valued that public health service of preventing MTCT should be equal to all pregnant women.3.Inoculation rates of HB vaccines and HBIG were both higher in the project of preventing MTCT in Shenzhen,and the effect of the above project was better than that in nationwide general level.