Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 21, 2011; 17(31): 3640-3644
Published online Aug 21, 2011. doi: 10.3748/wjg.v17.i31.3640
A nested case-control study of maternal-neonatal transmission of hepatitis B virus in a Chinese population
Li-Zhang Chen, Wen-Qi Zhou, Shu-Shan Zhao, Zhi-Yu Liu, Shi-Wu Wen
Li-Zhang Chen, Wen-Qi Zhou, Shu-Shan Zhao, Shi-Wu Wen, School of Public Health, Central South University, Changsha 410078, Hunan Province, China
Shu-Shan Zhao, Eight-Year Program, Xiangya School of Medicine, Central South University, 410008 Changsha, Hunan Province, China
Zhi-Yu Liu, Maternal and Child Health Hospital of Hunan Province, Changsha 410008, Hunan Province, China
Shi-Wu Wen, The OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, 501 Smyth Road, Box 241, Ottawa K1H 8L6, Canada
Shi-Wu Wen, Ottawa Health Research Institute Clinical Epidemiology Program, Canada; Department of Epidemiology and Community Medicine, University of Ottawa, K1H 8L6, Canada
Author contributions: Chen LZ designed research and wrote the paper; Zhou WQ, Zhao SS and Liu ZY performed research and analyzed data; Wen SW revised and participated in the editing of the manuscript; all authors read and approved the final manuscript.
Supported by Hunan Ministry of Science and Technology, No. 06FJ3177, China
Correspondence to: Dr. Li-Zhang Chen, School of Public Health, Central South University, 110 Xiangta Road, Changsha 410078, Hunan Province, China.
Telephone: +86-731-88836996 Fax: +86-731-88836162
Received: January 15, 2011
Revised: March 1, 2011
Accepted: March 8, 2011
Published online: August 21, 2011

AIM: To examine the determinants of maternal-neonatal transmission of hepatitis B virus (HBV).

METHODS: A nested case-control study was conducted in Changsha, Hunan, People’s Republic of China from January 1, 2005 to September 31, 2006. To avoid potential maternal blood contamination, we collected vein blood of newborns immediately after birth and before initial hepatitis B vaccination to determine the HBV infection status of the newborn. For each HBsAg-positive infant, one HBsAg-negative infant born to an HBsAg-positive mother was matched by hospital at birth (same), gender (same), and date of birth (within 1 mo). A face-to-face interview was conducted to collect clinical and epidemiological data. Conditional logistic regression analysis was used to estimate the independent effects of various determinants on maternal-neonatal transmission of HBV.

RESULTS: A total of 141 HBsAg-positive infants and 141 individually matched HBsAg-negative infants were included in the final analysis. Maternal first-degree family history of HBV infection, intrahepatic cholestasis, and premature rupture of membranes were risk factors for perinatal transmission of HBV, whereas systematic treatment and HBV immunoglobulin injections for mothers with HBV infection were protective factors for maternal-neonatal transmission of HBV, after adjustment for potential confounding factors.

CONCLUSION: For HBsAg-positive mothers, systematic treatment, HBV immunoglobulin administration, and controlling intrahepatic cholestasis and pregnancy complications may reduce the incidence of perinatal transmission of HBV.

Keywords: HBsAg-positive, Hepatitis B virus, Perinatal transmission: Nested case-control study