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目的应用病例对照研究方法探讨孕期性行为与乙型肝炎病毒(HBV)宫内感染关系。方法以212例HBsAg阳性孕妇的连续性病例及其新生儿为研究对象,以外周血HBsAgAbbott检测S/N值≥5的新生儿为病例组,余为对照组,收集孕妇孕期性行为、母亲HBeAg状态及其他相关因素等流行病学资料,采用单因素分析、多因素logistic回归分析等方法探讨上述因素与HBV宫内感染关系。结果214例新生儿有10例新生儿发生宫内感染。孕中期性行为是HBV宫内感染的危险因素,OR值为9.15(1.10～76.28),且有剂量反应关系。既往确定的母亲HBeAg、HBVDNA阳性也是HBV宫内感染危险因素。交互作用分析提示孕中期性行为与母亲HBeAg有协同作用。结论孕中期性行为是HBV宫内感染新发现的危险因素,值得进一步研究。为预防HBV宫内感染应孕前抑制病毒复制,孕期节制性行为。
Objective To explore the relationship between sexual behavior during pregnancy and intrauterine infection of hepatitis B virus (HBV) by case-control study. Methods 212 consecutive HBsAg-positive pregnant women and their newborns were studied. Peripheral blood HBsAg Abbott was used to detect newborns with S / N ≥5, and the rest were control group. The pregnant women ’s sexual behavior during pregnancy, HBeAg Status and other related factors such as epidemiological data, univariate analysis, multivariate logistic regression analysis and other methods to explore the relationship between these factors and HBV intrauterine infection. Results In 214 newborns, 10 newborns developed intrauterine infection. Interim pregnancy is a risk factor for HBV intrauterine infection, OR value of 9.15 (1.10 ~ 76.28), and a dose-response relationship. Previously confirmed mothers HBeAg, HBVDNA positive is also a risk factor for HBV intrauterine infection. Interaction analysis suggests that there is a synergistic effect of HBeAg in mothers during the second trimester. Conclusions The second trimester sexual intercourse is a newly discovered risk factor of intrauterine infection of HBV, which deserves further study. To prevent HBV intrauterine infection should be suppressed before pregnancy, viral replication, abstinence control behavior during pregnancy.