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目的:探讨乙肝病毒(HBV)携带产妇母乳喂养的安全性。方法:选取该院产科单胎足月分娩的HBV携带产妇324例为研究对象,采集分娩前静脉血、分娩后初乳、新生儿脐带血、6月后新生儿外周血,检测HBV-M和HBV-DNA,进行统计学分析。结果:大三阳组分娩前血清HBV-DNA含量≥1×106copies/ml的产妇明显多于含量<1×106copies/ml的产妇,差异有统计学意义(χ2=4.06,P=0.04);小三阳组分娩前血清HBV-DNA含量≥1×106copies/ml的产妇明显少于含量<1×106copies/ml的产妇,差异有统计学意义(χ2=5.72,P=0.02)。凡是血清中HBV-DNA<1×106copies/ml的产妇,其分娩后初乳中均未检出HBV-DNA;而血清中HBV-DNA≥1×106copies/ml的产妇,乳汁中HBV-DNA检出率与血清的HBVDNA含量成正比,差异有统计学意义(r=0.208,P=0.040)。喂养后6个月,人工喂养组婴儿的外周血未检出HBV-DNA,而母乳喂养组有8例婴儿呈HBV-DNA阳性,占12.90%,差异有统计学意义(χ2=8.55,P=0.00)。结论:分娩前血清HBVDNA≥1×106copies/ml的HBV携带产妇施行母乳喂养需慎重。
Objective: To investigate the safety of hepatitis B virus (HBV) carrier breastfeeding. Methods: A total of 324 pregnant women with HBV-borne maternal obstetric delivery were enrolled in this study. Venous blood before delivery, colostrum after delivery, umbilical cord blood of neonates and peripheral blood of neonates after 6 months were collected. HBV-M and HBV-DNA, for statistical analysis. Results: The levels of HBV-DNA in preterm delivery group were significantly higher than those in preterm delivery group with HBV DNA ≥1 × 106copies / ml (χ2 = 4.06, P = 0.04) The positive rate of maternal HBV DNA before delivery> 1 × 106copies / ml was significantly less than that of maternal <1 × 106copies / ml, the difference was statistically significant (χ2 = 5.72, P = 0.02). All the serum HBV-DNA <1 × 106copies / ml of mothers, postpartum colostrum did not detect HBV-DNA; and serum HBV-DNA ≥ 1 × 106copies / ml of maternal and breast milk HBV-DNA test The rate of HBVDNA was positively correlated with serum HBV DNA level (r = 0.208, P = 0.040). Six months after feeding, HBV-DNA was not detected in peripheral blood of artificially fed infants, while 8 infants in breastfeeding group were HBV-DNA positive (12.90%, χ2 = 8.55, P = 0.00). CONCLUSIONS: Before delivery, HBV-bearing mothers with serum HBVDNA≥1 × 106copies / ml should be cautious when breastfeeding.