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目的探讨对婴儿采取免疫措施后,乙肝病毒(HBV)携带母亲采用不同的喂养方式对母婴HBV传播的影响。方法检索PubMed、Medline、Embase、Cochrane图书馆、中国期刊全文数据库、维普中文科技期刊数据库和万方数据库等,对免疫干预后比较母乳喂养和人工喂养婴儿HBV感染率的前瞻性研究进行Meta分析。结果 10篇随机对照试验满足纳入条件进入Meta分析,其中母乳喂养组婴儿873例,人工喂养组751例。在对婴儿进行免疫干预后,母乳喂养组与人工喂养组的6～12月龄婴儿乙肝表面抗原或HBV DNA阳性率差异无统计学意义(7个研究:OR=0.86,95%CI=0.51～1.45,P=0.56;I2=0,P=0.99);母乳喂养组与人工喂养组6～12月龄婴儿的乙肝表面抗体阳性率差异无统计学意义(8个研究:OR=0.98,95%CI=0.69～1.40,P=0.93;I2=0,P=0.99)。结论 HBV携带者母亲采用不同的喂养方式对免疫干预措施阻断母婴HBV传播没有影响,HBV携带产妇母乳喂养并不增加HBV母婴传播的风险。
Objective To investigate the effects of different immunization methods on the transmission of HBV in mothers and infants after adopting immunization to infants. Methods PubMed, Medline, Embase, Cochrane Library, Chinese Journal Full-text Database, VIP Chinese Journal of Science and Technology Database and Wanfang Database were searched for meta-analysis of the prospective study comparing HBV infection rate of breastfeeding and artificially fed infants after immunization. Results Ten randomized controlled trials were included in the meta-analysis to meet the inclusion criteria, including 873 infants in breast-feeding group and 751 in artificial feeding group. There was no significant difference in HBsAg or HBV DNA positive rate in infants aged 6 ~ 12 months after breast-feeding and artificial feeding (7 studies: OR = 0.86, 95% CI = 0.51 ~ 1.45, P = 0.56; I2 = 0, P = 0.99). There was no significant difference in the positive rate of HBsAg between breastfeeding group and artificial feeding group of 6-12 months old infants (8 studies: OR = 0.98, 95% CI = 0.69-1.40, P = 0.93; I2 = 0, P = 0.99). Conclusion Different carriers of mothers with HBV carriers have no effect on the interruption of HBV transmission by maternal and infant immunization interventions. Breastfeeding by HBV carriers does not increase the risk of mother-to-child transmission of HBV.