Breastfeeding initiation: is this influenced by maternal hepatitis B infection?
OBJECTIVE
To elucidate the effect of hepatitis B virus (HBV) infection on breastfeeding uptake in Chinese mothers in an endemic region.


METHODS
A retrospective cohort study on 63 885 consecutive pregnant delivered between January 1997 and June 2008, were extracted from computerized database to examine the relationship between breastfeeding uptake and maternal HBV status, adjusted for demographic factors.


RESULTS
A total of 6593 (10.3%) women were hepatitis B surface antigen (HBsAg)-positive, with an annual prevalence of around 10%. In the study period, 29 869 (46.8%) practised breastfeeding, and its prevalence ranged from 35.4 to 54.8% with an increasing trend throughout the years (p < 0.001). HBsAg-positive mothers had a significantly lower rate of breastfeeding (39.2 vs. 47.6% p < 0.001). Multiparas had higher incidence of HBV infection (10.9 vs. 9.8%, p < 0.001) and lower breastfeeding rate (42.2% versus 51.0%, p < 0.001) when compared with primiparas. Among those factors, maternal HBV infection had the strongest negative association with breastfeeding (adjusted odd ratio (aOR) = 0.726, 95% confidence interval (CI): 0.689-0.765).


CONCLUSIONS
Our results suggested maternal HBV infection was one of the factors for the persistently low breastfeeding rate in Hong Kong over the past decades. To promote breastfeeding, it is necessary to generate definitive data on its safety regarding to mother-to-child transmission (MTCT) of HBV in order to allay the fear and anxiety in HBsAg-positive mothers.
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, P R China. kittongl@cuhk.edu.hk
Viola Kit
VK
Tong Leung
Terence T
TT
Lao
Stephen Sik Hung
SS
Suen
Oi Ka
OK
Chan
Daljit
D
Singh Sahota
Tze Kin
TK
Lau
Tak
T
Yeung Leung
D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data; D001942:Breast Feeding / Q000379:methods / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control / Q000706:statistics & numerical data; D009035:Mothers / Q000706:statistics & numerical data; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D055815:Young Adult
D006514:Hepatitis B Surface Antigens