目的对2018—2020年广东省深圳市宝安区预防乙肝母婴传播状况及效果进行分析。方法选择2018—2020年于深圳市宝安区分娩的乙肝表面抗原(hepatitis B surface antigen,HBsAg)阳性产妇及其所生活产儿为研究对象,对HBsAg阳性产妇检测、治疗情况,以及乙肝暴露儿童的随访、免疫后血清学检测等指标进行统计分析。结果 2018—2020年深圳市宝安区产妇总数为139 980例,产妇孕期乙肝检测率由2018年的98.31%上升至2020年的98.90%;HBsAg阳性产妇乙肝病毒(hepatitis B virus,HBV) DNA检测率和高病毒载量抗病毒治疗率分别由2018年的49.59%和28.68%上升至2020年的91.94%和83.98%,差异均有统计学意义(均P<0.05)。2018—2020年乙肝暴露儿童首针疫苗接种率和乙肝免疫球蛋白注射率分别为99.98%和99.94%。2018—2019年出生的乙肝暴露儿童8 614例,随访成功7 291例(84.64%),其中乙肝疫苗全程接种数7 250例(99.44%),接受免疫后血清学检测3 658例(50.17%),HBsAg阳性10例,乙肝母婴传播率为0.27%(10/3 658);2020年出生的3 633例乙肝暴露儿童的随访工作仍在持续进行,需全部结案后方可统计相关数据。结论深圳市宝安区HBsAg筛检和联合免疫等预防乙肝母婴传播措施执行良好,但仍需创新服务模式和策略,提高乙肝暴露儿童免疫后血清学检测比例。

Objective To analyze the status and effect of prevention of mother-to-child transmission of hepatitis B in Baoan District, Shenzhen from 2018 to 2020.Methods Hepatitis B surface antigen(HBsAg)-positive mothers who gave birth from 2018 to 2020 and their live newborns in Baoan District were recruited in study. Detection and treatment of HBsAg-positive mothers, follow-up and post-vaccination serological test for hepatitis B virus(HBV)-exposed children were analyzed in this research.Results The total number of pregnant women in Baoan District from 2018 to 2020 were 139 980. The rate of HBsAg testing during pregnancy increased from 98. 31% in 2018 to 98. 90% in 2020. The rate of HBV DNA detection and antiviral therapy with high viral load increased from 49. 59% and 28. 68% in 2018 to 91. 94% and 83. 98% in 2020, respectively(P< 0. 05). The average rate of 1 stdose hepatitis B vaccine and hepatitis B immunoglobulin(HBIG) coverage of HBV-exposed newborns were 99. 98% and 99. 94% from 2018 to 2020. A total of 7 291 infants(84. 64%) finished follow-up out of 8 614 HBV-exposed children born from 2018 to 2019, among which 7 250(99. 44%) had completed three doses hepatitis B vaccine. 3 658 had received post-vaccination serological test(50. 17%) and 10 had been tested as HBsAg-positive, the rate of mother-to-child transmission of HBV was 0. 27%(10/3 658). 3 633 children exposed to HBV born in 2020 is still in follow up progress, and relevant data can only be analyzed after all cases are closed.Conclusion Measures to prevention of mother-to-child transmission of hepatitis B such as HBsAg screening and combined immunization in Baoan District are well implemented, while innovative service models and strategies are still need to increase the proportion of post-vaccination serological test among HBV-exposed children.