[Analysis about clinical data of intrauterine infection of hepatitis B virus].
OBJECTIVE
To investigate a practical diagnostic method in clinic for fetuses infecting with hepatitis B (HBV) and study the mutual effects between fetal infection and clinical factors.


METHODS
Venous blood was drawn from 144 cases of HBV carrier mothers and their neonates. HBV DNA was detected by polymerase chain reaction (PCR) and hybridization, HBV M was detected by enzyme linked immunoadsorbent assay (ELISA), and aspartate aminotransferase/alanine aminotransferase (AST/ALT) was detected by IFCC. Umbilical blood and femoral blood was taken from 40 of 144 neonates for HBV DNA detection. Clinical data, neonatal AST and ALT level were compared between fetal infection group and control group.


RESULTS
(1) The fetal infectious rate was 22.9% (33/144). Comparing with peripheral venous blood sample, the sensitivity and positive predictive value of HBV DNA detected in cords was 100.0%, 80.0% respectively. Following up the infants, HBV DNA was found persistently positive in 7 of 28 intrauterine infectious infants 6 approximately 9 months after birth. HBsAg was found changing to be negative 1 month later in the infants with HBsAg positive at birth. (2) The fetal infectious rate in mothers with HBeAg (+) or HBV DNA (+) was 70.5%, 61.1% respectively which was significantly higher than that in mothers with HBeAg (-) or HBV DNA (-). P < 0.01. There was no significantly difference in mothers' age, gestational age, delivery way, birth weight (BW), body length (BL), Apgar score between fetal infectious group and control group. (3) The mean value of AST, ALT in fetal infectious group was (61.2 +/- 31.3) IU, (24.7 +/- 14.9) IU respectively, which was significantly higher than that in control group [(55.2 +/- 37.1) IU, (19.0 +/- 10.1) IU]. P < 0.01.


CONCLUSIONS
(1) Detection of HBV DNA in cord blood is a sensitive index for diagnosing fetal infection, however detection of peripheral venous blood is with the significance of making correct diagnosis. (2) HBsAg or HBV DNA positive in mothers is one of the risk factors of intrauterine infection. There is no relationship among fetal infection and mothers' age, gestational age, delivery way, neonates' sex, BW, BL. (3) The liver function of neonates infected with HBV intrauterinely maybe impaired to some extent.
Liu
Yinglin
Y
Department of Obstetrics and Gynecology, Sun Sat-Sen Memorial Hospital, Guangzhou 510120, China.
Kuang
Jianquan
J
Zhang
Rui
R
Lin
Shufen
S
Ding
Hong
H
Liu
Xingzhi
X
D000328:Adult; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008099:Liver / Q000503:physiopathology; D011247:Pregnancy
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens