The Study Of The Transportion From Mother To Baby And The HBV Intrauterine Infection

Objective : To explore the route that the HBsAg positive pregnant women's cell entered fetal circulation ,and to study the mechanism of HBV intrauterine transmission that the cell transported HBV to fetus and infected fetus.Methods: 160 pregnant women and 160 newborns were collected from July ,2006 to March ,2008 in the First Affiliated Hospital of Nanchang University. By detecting the inserting/deletion polymorphisms involving the glutathione S-transferase M1 (GSTM1) and angiotensin-converting enzyme genes (ACE) ,the cell transportion from mother to baby were determined by allele-specific PCR (AS-PCR) and heminested PCR(hemi-nPCR) . The quatity of HBV DNA和PBMC HBV DNA in mothers and newborns was studied using a fluorescence quantitative PCR (FQ-PCR) assay .Results:①1 Regarding GSTM1 ,ACE as maternal specific alleles :56 mother-baby pairs were recruited from hemocyte specimens as informative cases , then examining 31(55.35%) newborns'blood cell out of 56 informative cases had maternal cell DNA.②Regarding HBV DNA positive in the newborns'PBMC as HBV intrauterine infection, the rate of HBV intrauterine infection in the group of cell-transportion from mother to baby was higher than the group of no-cell-transportion from mother to baby(χ213.532,P<0.01), There was association between the cell transportion from mother to baby and HBV DNA positive in the newborns'PBMC.③Regarding HBV DNA positive in the newborns'peripheral blood as HBV intrauterine infection, There was indiscriminationthe in the rate of HBV intrauterine infection in the group of cell-transportion from mother to baby with the group of no-cell-transportion from mother to baby(χ20.355, P>0.5), There was no- association between the cell transportion from mother to baby and HBV DNA positive in the newborns'peripheral blood.④Regarding HBV DNA positive in the newborns'PBMC or/and in the newborns'peripheral blood as HBV intrauterine infection, the rate of HBV intrauterine infection in the group of cell-transportion from mother to baby was higher than the group of no-cell-transportion from mother to baby(χ214.641,P<0.01), There was association between the cell transportion from mother to baby and HBV DNA positive in the newborns'PBMC or/and in the newborns'peripheral blood .⑤The quatity of HBV DNA in pregnant women'peripheral blood is linear correlate with the the quatity of HBV DNA in pregnant newborns'peripheral blood with the coefficient correlation exceeded zero , the latter turned higher with the former turned higher . because of r=0.481, the degree of the close of the two quatities was common..⑥The quatity of HBV DNA in pregnant women'PBMC is linear correlate with the the quatity of HBV DNA in pregnant newborns'PBMC with the coefficient correlation exceeded zero , the latter turned higher with the former turned higher . because of r=0.783, the degree of the close of the two quatities was closer .Conclusions:1,the HBsAg positive pregnant women's cellcan entered fetal circulation .2,There was significantly association between the cell transportion and HBV DNA positive in the newborns'PBMC . There was significantly association between the cell transportion and HBV intrauterine infection .3,The assay of the quatity of HBV DNA in PBMC is the important index for the diagnosis of HBV intrauterine transmission .4,The assay of FQ-PCR had better sensitivity and specificity. It can quantitate analysis the circulating DNA. These results also raise the possibility that measurement of circulating DNA may prove useful as a marker for the diagnosis and/or monitoring of gravidity affiliated HBV.