摘要
目的了解行介入性诊断的乙肝孕妇发生垂直传播的风险情况。方法回顾性分析2017年7月至2018年6月间来广东省妇幼保健院产前诊断科行介入性产前诊断、符合纳入标准的乙肝表面抗原(HBsAg)阳性孕妇及其所生婴儿的临床资料,总结不同穿刺类型、不同穿刺指征、是否合并乙肝e抗原(HBeAg)阳性等情况下的母婴垂直传播风险。结果本研究共纳入131例(含双胎5例)乙肝孕妇和136例所生婴儿,共3例(2.21%)在乙肝联合免疫后依然被检出感染乙肝;HBeAg阴性和HBeAg阳性孕妇所生婴儿发生感染的几率分别为1.09%(1/92)和5.71%(2/35);乙肝病毒DNA定量超过106IU/ml和107IU/ml的垂直传播率分别为4.35%(1/23)和5.00%(1/20);行羊膜腔穿刺术、脐静脉穿刺术和绒毛吸取术的乙肝孕妇发生垂直传播的几率分别为1.11%(1/90)、2.56%(1/39)和14.29%(1/7);因超声异常表现和其他非超声异常指征行介入性产前诊断孕妇发生垂直传播的风险分别为2.82%(2/71)和1.54%(1/65);10例孕妇孕期接受了抗病毒治疗,该10例所生婴儿均未发生感染。结论乙肝孕妇行介入性产前诊断有发生母婴垂直传播的风险,仍需大样本研究进一步探讨。
Objective To evaluate the risk of vertical transmission in the pregnant women with hepatitis B who underwent the invasive prenatal diagnosis.Methods The information of pregnant women with positive hepatitis B surface antigen(HBsAg)undergoing invasive prenatal diagnosisin the Prenatal Diagnosis Department of Guangdong Women and Children’s Hospital from July 2017 to June 2018 and their babies wereretrospectively analyzed,and then the risk of vertical transmission in the different types of punctures,the different indications,the different HBeAg and different HBV DNA copies were evaluated.Results A total of 131(including 5 twins)pregnant women and 136 infants were included in this study.3 cases(2.21%)were still infected with hepatitis B virus after combined immunization.The rates of infection in the infants born to HBeAg-negative and HBeAg-positive pregnant women are 1.09%(1/92)and 5.71%(2/35),respectively.The rates of infection in the infants whose mothers has HBV DNA copies exceeding 106IU/ml and 107IU/ml are 4.35%(1/23)and 5.00%(1/20),respectively.The rates of vertical transmission in the pregnant women with amniocentesis,percutaneous umbilical blood sampling,and chorionic villus sampling are 1.11%(1/90),2.56%(1/39),and 14.29%(1/7),respectively.There are 10 mothers taking antiviral drug during the pregnancy and none of their infants were positive for HBsAg.Conclusion The pregnant women with hepatitis B underwent invasive prenatal diagnosis have the risk for vertical mother-to-child transmission and large-scale studies are needed to further explore.
作者
熊盈
方利元
朱娟
李玲
麦明琴
易慧
潘小英
Xiong Ying;Fang Liyuan;Zhu Juan;Li Ling;Mai Mingqin;Yi Hui;Pan Xiaoying(Guangdong Women and Children Hospital,Guangzhou 511400,China)
出处
《中国产前诊断杂志（电子版）》
2020年第1期1-5,共5页
Chinese Journal of Prenatal Diagnosis(Electronic Version)
基金
广东省医学科学技术研究基金项目(A2018260)。
关键词
乙肝病毒
介入性产前诊断
母婴垂直传播
Hepatitis B virus
Invasive prenatal diagnosis
Mother-to-child transmission
