摘要
目的 通过对上海市乙肝感染孕产妇所生高暴露风险儿童全程免疫接种后血清学检测结果分析,了解影响检测的主要因素,为持续优化随访检测策略提供依据。方法 以2021年1月1日-2024年8月31日高母婴传播风险乙肝感染孕产妇所生儿童为研究对象,分析目标儿童全程免疫接种后血清学检测结果与影响因素。结果 2021年1月1日-2024年8月31日出生的13 772例乙肝感染孕产妇所生儿童中,高暴露风险儿童占比18.46%(2 542/13 772),失访率2.68%(66/2 466),抗原抗体血清学检测率为79.20%(1 953/2 466)。高暴露风险儿童乙肝母婴传播率为0.45%(11/2 466)。乙肝抗原抗体血清学未检测率18.13%(447/2 466)。Logistic回归分析显示,母亲初检孕周≤13周(OR=1.684,P<0.001)和孕期接受抗病毒治疗(OR=1.415,P=0.003)所生乙肝高暴露风险儿童接受检测的比例更高。结论 上海市已实现乙肝母婴传播的有效控制,但仍需针对未检测人群的核心影响因素,通过“宣教精准化、服务便捷化、管理一体化”的综合干预,提升血清学检测覆盖率,最终形成“知识-信念-行为”的协同促进体系,巩固消除乙肝母婴传播成果。
Objective This study aimed to analyze the post-full immunization serological testing results of high-exposure-risk children born to hepatitis B virus(HBV)-infected pregnant women in Shanghai,identify key factors influencing test,and provide evidence-based support for continuously optimizing follow-up and testing strategy.Methods Study subjects were high-exposure-risk children born to pregnant women at high risk of HBV mother-to-child transmission(MTCT)in Shanghai from January 1,2021 to August 31,2024.Post-full immunization serological testing results and associated factors were analyzed,with logistic regression used to identify independent influencing factors.Results Among 13772 children born to HBV-infected pregnant women during the study period,18.46%(2542/13772)were classified as high-exposure-risk.Of 2466 followed-up high-exposure-risk children,the loss-tofollow-up rate was 2.68%(66/2466),and the HBV antigen-antibody serological testing rate was 79.20%(1953/2466).The HBV MTCT rate among high-exposure-risk children was 0.45%(11/2466),and the HBV antigen-antibody serological non-testing rate was 18.13%(447/2466).Logistic regression analysis showed that children born to mothers who underwent their first prenatal examination at or before 13 weeks of gestation(OR=1.684,P<0.001)and those whose mothers received antiviral treatment during pregnancy(OR=1.415,P=0.003)were more likely to complete HBV serological testing.Conclusion Shanghai has achieved effective control of HBV MTCT.However,targeted interventions are still needed to address key factors associated with non-testing,such as implementing comprehensive measures including“precise education,convenient services,and integrated management”to improve HBV serological testing coverage.Ultimately,a“knowledge-belief-behavior”synergistic promotion mechanism should be established to consolidate the achievements of eliminating HBV MTCT.
作者
步晓颖
朱宇清
杜莉
杨皓云
陈国花
程妤奋
杨瑜麟
BU Xiaoying;ZHU Yuqing;DU Li;YANG Haoyun;CHEN Guohua;CHENG Yufen;YANG Yulin(Shanghai Maternal and Child Health Center,Shanghai 200062,China;Shanghai Clinical Center for Laboratory Medicine,Shanghai 200126,China;School of Public Health,Fudan University,Shanghai 200032,China;Maternal and Child Health Care Center of Jinshan District,Shanghai 201599,China)
出处
《中国妇幼卫生杂志》
2025年第6期461-466,共6页
Chinese Journal of Women and Children Health
基金
2025年度上海市疾病预防控制政策研究课题(2025JZ22)
2025年度上海市公共卫生研究专项课题(2025GKM13)。
关键词
乙肝感染孕产妇
高暴露风险儿童
免疫后血清学检测
随访
HBV-infected pregnant women
high-exposure-risk children
post-immunization serological testing
follow-up
