Maternal hepatitis B virus (HBV) DNA positivity and sexual intercourse are associated with HBV intrauterine transmission in China: a prospective case-control study.
OBJECTIVE
Hepatitis B virus (HBV) intrauterine transmission from infected mothers contributes significantly to the persistence of the high number of HBV carriers. The aim of this study was to identify potential risk factors for HBV intrauterine transmission.


METHODS
A case-control study was performed on pregnant women tested positive for HBsAg at Shaanxi Maternal and Neonatal Health Hospital, Xi'an, China, from September 2002 to October 2004. Serum samples were taken from infected women and their newborn infants and used for the detection of HBsAg. A structured standard questionnaire was used to collect demographic, medical and maternal data, and maternal HBV DNA, HBeAg, anti-hepatitis C virus and anti-hepatitis D virus were also assessed. Ten neonates validated as having HBV intrauterine transmission were selected as cases and others as controls.


RESULTS
The univariate analysis indicated that maternal HBeAg positivity (odds ratio [OR] = 5.96, 95% confidence interval [CI]: 1.61-22.12), HBV DNA positivity (OR = 12.09, 95% CI: 2.97-40.17) and sexual intercourse in the second trimester (OR = 9.15, 95% CI: 1.08-202.99) were significantly associated with an increased risk for HBV intrauterine transmission, whereas contraceptive measures before pregnancy (OR = 0.21, 95%CI: 0.04-0.99) were associated with a decreased risk. The multivariate analysis, however, identified maternal HBV DNA positivity (OR = 19.18, 95%: CI: 3.26-118.73) and sexual intercourse in the second trimester (OR = 1.29, 95%: CI: 1.00-1.66) as the only independent risk factors for HBV intrauterine transmission.


CONCLUSIONS
The risk of HBV intrauterine transmission increased with increased frequency of sexual intercourse. Therefore, it is concluded that maternal HBV DNA positivity and sexual intercourse in the second trimester are independent risk factors for HBV intrauterine transmission.
Shao
Zhong-Jun
ZJ
Department of Epidemiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Xu
De-Zhong
DZ
Xu
Jian-Qiu
JQ
Li
Jing-Hua
JH
Yan
Yong-Ping
YP
Men
Ke
K
Wang
Xue-Ping
XP
Zhang
Zhi-Ying
ZY
Jiang
Qin-Wu
QW
Zhang
Lei
L
D000328:Adult; D016022:Case-Control Studies; D002681:China; D003075:Coitus; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006509:Hepatitis B / Q000635:transmission*; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors
D004279:DNA, Viral