Effect of elective cesarean section on the risk of mother-to-child transmission of hepatitis B virus

BMC Pregnancy and Childbirth

Yi-Hua Zhou²  Biyun Xu¹  Shu Zhang⁴  Chenyu Xu³  Jian Wen³  Jie Chen⁴  Yali Hu² 

[1] Department of Biostatistics, Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing, China;Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China;Department of Obstetrics and Gynecology, Zhenjiang Fourth People's Hospital, Zhenjiang, China;Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing, China

关键词: Caesarean section;    Vaginal delivery;    Mother-to-child transmission;    Hepatitis B virus;   

Others  :  1138021
DOI  :  10.1186/1471-2393-13-119

 received in 2012-10-31, accepted in 2013-05-21,  发布年份 2013

【 摘 要 】

Background

Many clinicians and hepatitis B virus (HBV)-infected pregnant women prefer elective caesarean section (ECS) to prevent mother-to-child transmission of HBV, since some studies found higher transmission of HBV in infants born by vaginal delivery (VD) than by cesarean section. However, other studies showed that ECS does not reduce the risk of being infected with HBV in infants. In this study, we aimed to clarify whether ECS may reduce the risk of mother-to-child transmission of HBV.

Methods

Totally 546 children (1–7-year-old) born to 544 HBsAg-positive mothers from 15 cities and rural areas across Jiangsu Province, China, were enrolled. Of these children, 137 (2 pairs of twins) were born to HBeAg-positive mothers; 285 were delivered by ECS and 261 others by VD (one pair of twin in each group). HBV serologic markers were tested by enzyme or microparticle immunoassay.

Results

The maternal and gestational ages, maternal HBeAg-positive rates, and children’s ages, gender ratios, hepatitis B vaccine coverage and administrations of HBIG were comparable between ECS and VD groups (all p >0.05). The overall prevalence of HBsAg in the 546 children was 2.4%, with 2.5% (7/285) and 2.3% (6/261) in those born by ECS and VD respectively (p = 0.904). Further comparison of chronic HBV infection in the 137 children of HBeAg-positive mothers showed that the HBsAg-positive rates in ECS and VD groups were 10.3% (7/68) and 8.7% (6/69) respectively (p = 0.750), while the mothers had similar HBV DNA levels (2.38 × 10⁶ vs. 2.35 × 10⁶ IU/ml, p = 0.586). Additionally, the overall rate of anti-HBs ≥10 mIU/ml in the children was 71.6%, with 72.3% and 70.9% in those born by ECS and VD respectively (p = 0.717).

Conclusions

With the recommended immunoprophylaxis against hepatitis B, ECS does not reduce the risk of mother-to-child transmission of HBV. Therefore, ECS should not be used in HBsAg-positive pregnant women to prevent mother-to-child transmission of HBV.

【 授权许可】

   
2013 Hu et al.; licensee BioMed Central Ltd.

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