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目的:探讨剖宫产分娩能否降低乙肝高病毒血症孕妇母婴垂直传播发生率。方法:根据乙肝孕妇HBV-DNA滴度分为<103cps/ml、103~105cps/ml、105~107cps/ml和≥107cps/ml 4组,比较各组中经阴分娩及未临产剖宫产分娩的新生儿的HBV阳性率。结果:未临产剖宫产组、经阴分娩组的新生儿HBV总体阳性率分别为6.2%和10.3%,差异无统计学意义(P>0.05)。乙肝孕妇HBV-DNA<107cps/ml时,经阴分娩与未临产剖宫产出生的新生儿HBV阳性率比较,差异无统计学意义(P>0.05)。乙肝孕妇HBV-DNA≥107cps/ml时,剖宫产出生的新生儿HBV阳性率显著低于经阴分娩(4.4%vs37.8%,P<0.05﹚。结论:HBV-DNA≥107cps/ml的乙肝高病毒血症孕妇,未临产剖宫产可能降低乙型肝炎病毒母婴垂直传播率,应建立个性化乙肝母婴垂直传播防治方案。
Objective: To investigate whether cesarean delivery can reduce the incidence of mother-infant vertical transmission in pregnant women with hepatitis B and viraemia. Methods: HBV-DNA titers of hepatitis B pregnant women were divided into 4 groups: <103cps / ml, 103 ~ 105cps / ml, 105 ~ 107cps / ml and ≥ 107cps / ml. Of newborns with HBV positive rate. Results: The positive rate of HBV in newborns during non-labor caesarean section group and vaginal delivery group were 6.2% and 10.3%, respectively, with no significant difference (P> 0.05). HBV-DNA in pregnant women with HBV <107cps / ml, vaginal delivery and caesarean section were not born neonatal HBV positive rate, the difference was not statistically significant (P> 0.05). The positive rate of HBV in newborns born by cesarean section was significantly lower than that of vaginal delivery when HBV-DNA≥107cps / ml in pregnant women with HBV (4.4% vs37.8%, P <0.05). Conclusion: HBV-DNA≥107cps / ml hepatitis B viremia pregnant women, non-labor-induced cesarean section may reduce the vertical transmission rate of hepatitis B virus maternal and infant, should establish a personalized hepatitis B mother-infant vertical transmission control program.