A study on mothers with infected infants during second pregnancy for prevention of HBV mother-to-child transmission
Objective This study was aimed to investigate the causes of mother-to-child blocking failure in the first fetus of hepatitis B virus(HBV)infected mothers,the prevention of mother-to-child transmission(MTCT)during second pregnancy and mater-nal-infant outcomes.We evaluated the influence of antiviral therapy during pregnancy for preventing MTCT on children's growth and development.Methods Among HBV infected multiparas who underwent routine prenatal examinations at the Obstetrics Depart-ment of Nanjing University of Chinese Medicine Affiliated Nanjing Hospital from February 2017 to February 2019,we screened 34 mul-tiparas whose first child failed in the prevention of MTCT.HBV infected multiparas were grouped as first pregnancy group without anti-viral therapy and second pregnancy group with antiviral therapy in the second and third trimester.The incidence of pregnancy compli-cations and intrapartum complications during the two pregnancies were compared.Neonates were grouped as first pregnancy neonates and second pregnancy neonates to compare basic conditions,morbidi-ty,growth and development.Results All the 34 pregnant women were HBeAg positive during two pregnancies and the average HBV-DNA before first delivery was(2.27±1.95)×108 U/mL.Average HBV-DNA level was(2.43±2.15)×108 IU/ml during second pregnancy.Vi-ral loads before delivery all decreased to(1.98±6.23)×103 U/mL on average during second pregnancy with antiviral therapy.Cesarean delivery rate of second pregnancy group was higher than that of first pregnancy group.There was no statistical differences in the incidence of the adverse events perinatally and the intrapartum complica-tions(P>0.05).The standard hepatitis B vaccine and immunoglobin coverage rate after birth of the first newborns was 70.59%(24/34)and 50%(17/34).The coverage rate and timely of hepatitis B vaccine and immunoglobin was higher in second pregnancy group(P<0.05).Conclusion Antiviral treatment during pregnancy can effectively reduce the viral load of pregnant women with high viral load,and combined with neonatal immunization can reduce the incidence of neonatal hepatitis B virus infection.Antiviral therapy dur-ing pregnancy does not increase the incidence of perinatal adverse events and complications during labor,and not affect the growth and development of newborns.
prevention of mother-to-child transmissionHBV infectionantiviral therapygrowth and development
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