| Objective:1. To investigate the risk factors of hepatitis B virus (HBV) materno-fetal vertical transmission.2. To investigate the distribution of hIL-6 and hIL-6R in placental tissue and the correlation between hIL-6,hIL-6R and placental HBV infection.Methods:318 cases of HBsAg positive pregnant women and their babies respectively, who were examined and laboured at the first affiliated Hospital of Ji Nan University, were studied. The epidemiologic informations of mothers and babies during pregnant period and after-born were collected. The peripheral blood hepatitis B virus markers (HBV-M) of the pregnant woman and their newborns, as well as the HBV markers detected in maternal milk within 24 hours after parturition, were collected. And the placenta tissues during parturition were collected for research.1. According to the follow-up results, all cases were divided into either infection group or non-infection groups, the clinical datas were analyzed, and the risk factors of placental HBV infection were selected.2. The HBV-M of peripheral blood in the pregnant woman and their newborns (0, 1, 6 months old) were detected by ELISA. The vertical HBV infection rates of the 2 newborn groups which applied and didn't applied HBIG were compared.3. The peripheral blood in the pregnant woman and their newborns were detected by ELISA. According to the parturition manner, all cases were divided into either normal labour group or Caesarean birth group. The vertical HBV infection rates of the 2 newborn groups were compared.4. The peripheral blood and milk of the HBsAg positive pregnant woman and the HBV-M of their newborns were detected by ELISA and Fluorescence Quantitative PCR (FQ-PCR). The correlation of maternal in the HBV-M situation and HBV-M positive rate of milk were analyzed. 91 HBsAg negative newborns, whose mothers' milk were HBsAg positive, were selected. According to the different feeding manner, these 91 cases were divided into either mother-milk feed group or manpower feed group, the neonatal infection rates of these 2 groups were compared.5. Immunohistochemical staining PV-9000 was applied to detect HBsAg in placentas and analyze the HBsAg positive rate of cells in every layer of them.6. HBsAg and hIL-6 in the HBsAg positive placenta tissue were detected by double-label immunofluorescence assays and their distributions were observed by the confocal laser scanning technique.7. HBsAg and hIL-6R in the HBsAg positive placenta tissue were detected by double-label immunofluorescence assays and their distributions were observed by the confocal laser scanning technique.Results:1. The follow-up results of infants showed that, using the HBsAg positive at 6-month infants as a diagnostic criteria for intrauterine HBV infection, infection group had 17 cases, non-infection group had 301 cases, and the rate of placental HBV infection was 5.35%. Maternal serum HBV-DNA positive, HBeAg positive were the risk factors of placental HBV infection.2. 176 cases that applied HBIG (among them which 25 cases applied HBIG＜3 times), 142 cases that didn't apply HBIG. There is a significant difference between these 2 groups in HBsAg positive rate of one-month and six-month old infant (P＜0.05).3. There are 158 cases of normal labour group and 132 cases of Caesarean birth group. There is a significant difference between these 2 groups in HBsAg positive rate of zero-month and six-month old infant (P＜0.05).4. There are 41 cases of mother-milk feed group and 50 cases of manpower feed group. No significant difference existed between these 2 infant groups in the HBsAg positive rate of zero-month,one-month and six-month old infant P＞0.05).5. There were 67 HBsAg positive placentas in 132 HBsAg positive pregnant women (the positive rate was 50.77%). The immunohistochemical result showed that there is a positive signal in the cell plasm and membrane of every layer of the placental tissue.6. Double-label immunofluorescence assays and the confocal laser scanning technique showed that HBsAg and hIL-6 existed in the same position of placental tissue.7. The positive signal of hIL-6R was indicated by trophoblastic cells, villous mesenchymal cells and vascular endothelial cells of placental tissue.8. Double-label immunofluorescence assays and the confocal laser scanning technique showed that HBsAg and hIL-6R existed in the same position of placental tissue.Conclusion:1. Maternal serum HBV-DNA,positive HBeAg and parturition manners are high risk factors of HBV materno-fetal vertical transmission.2. Applying HBIG takes effects lower the rate of blocking the HBV vertical transmission.3. The parturition manners are related with the placental HBV infection of infants. Compared with normal labour, Caesarean birth may reduce the the rate of HBV materno-fetal vertical transmission.4. The HBV infection of infants could be nothing to do with the feeding manners. Feeding by HBV positive lying-in women will be safe if proper immunity protection measures are used.5. The route of infection mediated by hIL-6R on placental cells maybe exists in placental HBV infection. |
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