摘要
目的探讨母乳喂养对HBV母婴传播的影响。方法2002年1月—2004年12月江苏地区HBsAg阳性的281例孕妇及其子女,其中30.2%孕妇乙肝病毒e抗原阳性。婴儿母乳喂养222例,人工喂养59例。所有儿童均接种过乙肝疫苗,37.0%同时注射HBIG。2009年10月—2010年3月随访采血,检测HBV血清学标志。结果母乳喂养组和人工喂养组孕妇年龄、分娩方式,儿童年龄、性别比及HBIG注射情况差异均无统计学意义(P>0.05)。281例儿童中,HBsAg阳性和乙肝表面抗体阳性分别为3.2%和58.0%。人工喂养组和母乳喂养组HBsAg阳性率分别为5.1%和2.7%(P>0.05),进一步比较85例乙肝病毒e抗原阳性母亲的子女感染情况,两组孕妇HBVDNA水平相近(2.285×106 Vs 2.350×106,P>0.05),人工和母乳喂养的儿童HBsAg阳性率分别为11.1%(3/27)和10.3%(6/58),差异无统计学意义(P>0.05)。结论慢性HBV感染母亲的婴儿经免疫预防后,母乳喂养并不增加HBV母婴传播风险。因此,新生儿注射HBIG和乙肝疫苗后,医务人员应鼓励包括HBeAg阳性在内的HBV感染产妇进行母乳喂养。
Objective To clarify whether breastfeeding of infants adds risk for the mother-to-child transmission of hepatitis B virus （HBV）. Methods Totally 281 HBsAg-positive pregnant women, in whom 30.2% were also HBeAg-positive, and their 281 infants born from 2002 to 2004, were investigated from October 2009 to March 2010. HBV serologic markers were tested by ELISA and HBV DNA was quantified by real-time PCR. Of the 281 children, 222 were breastfed and 59 formula-fed. All children had been vaccinated against hepatitis B and 37.0% received hepatitis B immunoglobulin （HBIG）. Results The pregnant women＇s age, delivery mode, children＇s age, gender ratio, and administration of HBIG in infants were comparable between breast- and formula-feeding groups （P〉0.05）. The overall prevalence of HBsAg-positive and anti-HBs in the children was 3.2% and 58.0% respectively. In formula- and breast-fed children, the HBsAg-positive rates were 5.1% and 2.7% respectively （P〉O.05）. Further comparison of HBV infection in children of the 85 HBeAg-positive mothers showed that formula- and breast-fed children （27 and 58 respectively） had comparable HBsAg-positive rate （11.1%Vs 10.3%, P〉0.05）, while their mothers had similar HBV DNA levels （2.285×106 Vs 2.350×106, P〉0.05）. Conclusion With the currently available immunoprophylaxis, breast-feeding of infants born to chronic HBV carriers, add no risk for the mother-to-infant transmission of HBV. Therefore, with administration of HBIG and hepatitis B vaccine, HBV-infected mothers should be encouraged to breastfeed their infants.
出处
《护理学报》
2013年第1期46-49,共4页
Journal of Nursing（China）
基金
国家临床重点专科护理项目(2011872)
江苏省母胎医学重点学科建设项目(XK201102)
江苏省自然科学基金(BK2008501)
江苏省人口和计划生育委员会"十一五"江苏省避孕节育生殖健康家庭保健行动计划
南京市卫生人才工程项目(2011024)
关键词
母乳喂养
HBV
母婴传播
免疫预防
breastfeeding
hepatitis B virus
mother-to-child transmission
immunoprophylaxis
