title: Breastfeeding of newborns by mothers carrying hepatitis B virus: a meta-analysis and systematic review.
abstract: OBJECTIVE
  To perform a systematic review of prospective studies to confirm the role of breastfeeding in mother-to-child transmission (MTCT) of hepatitis B virus (HBV).
  
  
  METHODS
  A database was constructed from MEDLINE, EMBASE, Cochrane Library, National Science Digital Library, and China Biological Medicine Database and through contact with experts in this field from January 1, 1990, to August 31, 2010.
  
  
  METHODS
  All studies were peer reviewed and met the preset inclusion standards.
  
  
  METHODS
  Breastfeeding.
  
  
  METHODS
  Data regarding HBV intrauterine infection, MTCT, maternal blood and breast milk infectiousness, infant immunoprophylaxis methods and response, and adverse events. The Mantel-Haenszel fixed-effects model was used for all analyses using odds ratios and 95% confidence intervals.
  
  
  RESULTS
  Ten qualified studies were included. All were clinical controlled trials, involving 751 infants in the breastfeeding group and 873 infants in the nonbreastfeeding group. As indicated by infant peripheral blood hepatitis B surface antigen or HBV DNA positivity at age 6 to 12 months, the odds ratio of MTCT of HBV in the breastfeeding group compared with that in the nonbreastfeeding group was 0.86 (95% confidence interval, 0.51-1.45) (from 8 clinical controlled trials, P = .56; I(2) = 0%, P = .99). As indicated by infant peripheral blood hepatitis B surface antibody positivity at age 6 to 12 months, the odds ratio of development of hepatitis B surface antibodies in the breastfeeding group compared with that in the nonbreastfeeding group was 0.98 (95% confidence interval, 0.69-1.40) (from 8 clinical controlled trials, P = .93; I(2) = 0%, P = .99). No adverse events or complications during breastfeeding were observed.
  
  
  CONCLUSIONS
  Breastfeeding after proper immunoprophylaxis did not contribute to MTCT transmission of HBV.
authors.affiliation: Department of Obstetrics and Gynecology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China. tua64317@temple.edu
authors.forename: Zhongjie
authors.initials: Z
authors.lastname: Shi
authors.forename: Yuebo
authors.initials: Y
authors.lastname: Yang
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.forename: Lin
authors.initials: L
authors.lastname: Ma
authors.forename: Ann
authors.initials: A
authors.lastname: Schreiber
authors.forename: Xiaomao
authors.initials: X
authors.lastname: Li
authors.forename: Wenjing
authors.initials: W
authors.lastname: Sun
authors.forename: Xuan
authors.initials: X
authors.lastname: Zhao
authors.forename: Xu
authors.initials: X
authors.lastname: Yang
authors.forename: Liran
authors.initials: L
authors.lastname: Zhang
authors.forename: Wenli
authors.initials: W
authors.lastname: Lu
authors.forename: Jin
authors.initials: J
authors.lastname: Teng
authors.forename: Yufang
authors.initials: Y
authors.lastname: An
mesh_terms: D001942:Breast Feeding; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000517:prevention & control / Q000635:transmission*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008895:Milk, Human / Q000821:virology*; D009035:Mothers; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000517:prevention & control / Q000821:virology
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens