Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Apr 29, 2024
Date Accepted: Aug 6, 2024
Investigation on Mother to Child Transmission of Hepatitis B in Yinchuan, China: Cross-Sectional Survey Study
ABSTRACT
Background:
Hepatitis B poses a significant global public health challenge, with mother-to-child transmission (MTCT) being the primary method of hepatitis B virus (HBV) transmission. The prevalence of HBV infection in China is the highest in Asia and it carries the greatest burden globally.
Objective:
This study aims to critically evaluated the existing local strategies for preventing MTCT and proposed potential enhancements, by conducting analyses on the prevalence of hepatitis B among pregnant women and their neonates in Yinchuan.
Methods:
From 2017 to 2021, 947 HBsAg-positive pregnant women and 960 neonates were enrolled and 61 neonates with HBsAg-positive cord blood test result were followed. Test results for HBV markers (HBsAg, HBsAb, HBeAg, HBeAb, HBcAb, HBV DNA) were collected and analyzed.
Results:
The prevalence of HBV among pregnant women was 2.52%, with a declining trend year after year. During the period from 2018 to 2020, only 33.02% of eligible pregnant women received antiviral medication treatment. Delivery (2=8.023, P=.005), maternal HBeAg (2=24.785, P<.001), and maternal HBV DNA (2=30.751, P<.001) were strongly associated with cord blood HBsAg positivity. Among the 61 neonates with HBsAg-positive cord blood test result who successfully completed follow-up at 6-56 months of age, only 2 of them were infected with HBV and their mothers all had detectable HBV DNA levels should have received standard antiviral therapy. The results of the HBsAb positive rate and titer test indicated a gradual decline in the immunity of vaccinated infants to HBV as the follow-up interval increased.
Conclusions:
The clinical relevance of HBV markers detection in cord blood is restricted within the current prevention measures for MTCT. Meanwhile, the emphasis is placed on the significance of public education regarding hepatitis B and the reinforcement of postnatal follow-up for the prevention of MTCT.
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