Effect Of Different Delivery Modes On Mother-to-child Vertical Transmission Of Hepatitis B Virus

Objective:This study was undertaken to evaluate the effects of different delivery patterns on mother-to-child vertical transmission of hepatitis B virus.Methods:Selected 68 cases of hepatitis B surface antigen HBsAg(+) gravidas who had regular prenatal checkup on August 2009-March 2010 at the First Affiliated Hospital of Jinan University as research section. At the same time, randomly selected 64 normal gravidas with HBsAg(-) were as control group. All above had signed informed consent. And divided into different subgroups:natural delivery group and cesareansection group.1.The research group was to detect quality identification of hepatitis B virus-markers, quantification of placental alkaline phosphatase(PLAP) and HBsAg by enzyme linked immunosorbent assay(ELISA) in peripheral blood of HBsAg(+) gravidas in antepartum. To detect the quantification of hepatitis B virus-deeoxyribose nucleic acid (HBV-DNA) by fluorescence quantitative polymerase chain reaction(FQ-PCR). To quantify the PLAP and HBsAg by ELISA of neonatal umbilical cord blood after delivery, to detect the quantification of hepatitis HBV-DNA by FQ-PCR. And detected hepatitis B virus-markers by ELISA and HBV-DNA by FQ-PCR respecitvely from peripheral blood in neonates within one day after birth.2.The control group was to quantify the PLAP in peripheral blood in HBsAg(-)gravidas in antepartum and in umbilical cord blood after delivery by ELISA.Results:1.The quantification of PLAP in umbilical cord blood in cesarean section group is lower than natural delivery group in both the research and control groups. There was significant difference (P< 0.05).2.The quantification of HBsAg in umbilical cord blood in cesarean section group was lower than natural delivery group in both sreseach and control groups. There was significant difference (P< 0.05).3.The amount of PLAP from umbilical cord blood in infants was increased with the prolonged first and second stage of labor. Pearson correlation coefficient r=0.35, P=0.01.4.HBV-DNA and HBsAg in peripheral blood in neonates were both negative in the research section. The positive rate of HBsAb, HBeAb, HBcAb and HBeAg were no significant differences(P>0.05).Conclusion:1.The cesarean delivery was more reduced transfussion from maternal to fetal than natural delivery for decreased the transmission rate of hepatitis B virus from mother to child vertical transmission during delivery.2.The prolonged stage of labor was positive correlation to PLAP value in neonatal umbilical cord blood, therefore the cesarean section would benefited blockaded mother to child vertical transmission of HBV.