title: Immunization interventions to interrupt hepatitis B virus mother-to-child transmission: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  This study aimed to determine the clinical efficacy of various immune interventions on mother-to-child transmission (MTCT) of hepatitis B virus (HBV).
  
  
  METHODS
  We retrieved different immune strategies on how to prevent MTCT reported in the literature from Chinese and English electronic databases from the viewpoint of intrauterine and extrauterine prevention. Relative risk (RR) and 95% confidence interval (CI) methods were used.
  
  
  RESULTS
  Twenty-five articles on intrauterine prevention and 16 on extrauterine prevention were included in the analysis. Intrauterine prevention could reduce infants' HBV infection rate (RR = 0.36, 95% CI: 0.28-0.45) and increase their anti-hepatitis B surface-positive rate (RR = 2.42, 95% CI: 1.46-4.01) at birth. Compared with passive immunization, passive-active immunization could reduce infants' HBV infection rate (RR = 0.66, 95% CI: 0.52-0.84) at birth, even at more than 12 months of age (RR = 0.54, 95% CI: 0.42-0.69). Subgroup analysis demonstrated similar results except for pregnant women who were hepatitis B surface antigen-positive. Funnel plots and Egger's tests showed publication bias mainly in intrauterine prevention not in extrauterine one.
  
  
  CONCLUSIONS
  The long-term protective effect of pregnant women injected with hepatitis B immunoglobulin during pregnancy should be further validated by large-scale randomized trials. Newborns of pregnant women who carried HBV should undergo a passive-active immunization strategy.
authors.affiliation: Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China. jinhui_hld@163.com.|Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China. jinhui_hld@163.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Jin
authors.affiliation: Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China. zhaoyy@163.com.
authors.forename: Yueyuan
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China. tan671111@163.com.
authors.forename: Zhaoying
authors.initials: Z
authors.lastname: Tan
authors.affiliation: Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China. njzhangxf@126.com.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China. zhaoyj@163.com.
authors.forename: Yaoyun
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China. wangbeilxb@seu.edu.cn.|Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China. wangbeilxb@seu.edu.cn.
authors.forename: Bei
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China. liupeiseu@163.com.|Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China. liupeiseu@163.com.
authors.forename: Pei
authors.initials: P
authors.lastname: Liu
mesh_terms: D002353:Carrier State / Q000188:drug therapy / Q000821:virology; D005260:Female; D006509:Hepatitis B / Q000635:transmission*; D006515:Hepatitis B virus; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000008:administration & dosage*; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D014761:Viral Hepatitis Vaccines / Q000008:administration & dosage*
chemical_list: D007136:Immunoglobulins; D014761:Viral Hepatitis Vaccines; C045213:hepatitis B hyperimmune globulin