Effect of antiviral therapy on physical growth and development of infants born to women infected with hepatitis B virus
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摘要:
目的 了解广东省广州市乙型肝炎病毒(HBV)感染孕妇孕期抗病毒治疗对其子代体格生长发育的影响。 方法 采用前瞻性队列研究,于2018年5月至2021年8月期间,对招募入组的乙肝表面抗原(HBsAg)阳性产妇所生婴儿进行定期追踪随访,孕期进行抗病毒治疗的HBV感染产妇所生儿童为暴露组,孕期未进行抗病毒治疗的HBV感染产妇所生儿童为对照组,采用广义估计方程等方法分析孕期抗病毒治疗对婴儿体重、身长发育的影响。 结果 研究共纳入663名HBV感染产妇所生婴儿,其中115名(17.35%)为暴露组,548名(82.65%)为对照组。 暴露组和对照组婴儿在1、3、6、12月龄时低体重、生长迟缓、消瘦的发生率差异无统计学意义(P>0.05),年龄别体重Z分、年龄别身长Z分和身长别体重Z分差异亦无统计学意义,且与世界卫生组织的参考标准差异无统计学意义。 暴露组婴儿年龄别身长Z分是对照组婴儿的0.585倍(P=0.021)。 结论 HBV感染孕妇孕期抗病毒治疗对其子代婴儿期体重和身长发育无影响。 Abstract:Objective To explore the effect of antiviral therapy during pregnancy on the physical growth and development of infants born to women infected with hepatitis B virus (HBV) in Guangzhou. Methods A prospective cohort study was conducted for a follow up in the infants born to HBsAg-positive women recruited from May 2018 to August 2021. Children born to HBV-infected women who received antiviral therapy during pregnancy were classified as exposure group, while children born to HBV-infected mothers who received no antiviral therapy during pregnancy were classified as control group. Generalized estimating equation was used to analyze the effects of antiviral treatment during pregnancy on infant weight and length development. Results A total of 663 infants born to HBV-infected women were included in this study, of whom 115 (17.35%) were divided into the exposure group and 548 (82.65%) were divided into the control group. There were no significant differences in incidences of underweight, stunting and wasting between exposure group and control group at age 1, 3, 6 and 12 months(P>0.05). There were no significant differences between the two groups in Z-score for age/weight, Z-score for age/length, and Z-score for length/weight. And the difference with the WHO reference standard was not statistically significant. The age/length Z-score was 0.585 times higher in the infants in exposure group than in the infants in control group (P=0.021). Conclusion The antiviral treatment during pregnancy of HBV-infected women had no effect on the body weight and length of their babies in infancy. -
Key words:
- Hepatitis B virus /
- Pregnancy /
- Antiviral therapy /
- Infant /
- Growth and development
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表 1 暴露组和对照组婴儿母亲基本特征和分娩情况比较
Table 1. Comparison of basic and delivery information of mothers infected with HBV between exposure group and control group
变量 暴露组
(n=115)对照组
(n=548)P值 母亲分娩时年龄
(岁,$\bar{x} \pm s$)29.97±4.48 31.16±4.99 0.019 母亲民族 0.347 汉族 114 (99.13) 532 (97.08) 其他 1 (0.87) 16 (2.92) 母亲文化程度 0.057 初中及以下 26 (22.61) 152 (27.74) 高中(含职高) 26 (22.61) 141 (25.73) 大专 19 (16.52) 114 (20.80) 本科及以上 44 (38.26) 141 (25.73) 母亲职业 0.006 待业 11 (9.57) 112 (20.44) 从业 104 (90.43) 436 (79.56) 母亲户籍 0.001 广州 99 (86.09) 385 (70.26) 非广州 16 (13.91) 163 (29.74) 产次 0.048 初产妇 66 (57.39) 259 (47.26) 经产妇 49 (42.61) 289 (52.74) 母亲HBeAg <0.01 阴性 22 (19.13) 413 (75.36) 阳性 93 (80.87) 135 (24.64) 婴儿性别 0.760 男性 66 (57.39) 306 (55.84) 女性 49 (42.61) 242 (44.16) 分娩方式 0.163 顺产 57 (49.57) 310 (56.57) 助产 8 (6.96) 20 (3.65) 剖宫产 50 (43.48) 218 (39.78) 出生胎龄
(d,$\bar{x} \pm s$)269.90±11.40 270.00±11.50 0.931 足月产 103 (89.57) 509 (92.88) 0.225 早产 12 (10.43) 39 (7.12) 出生体重
(g,$\bar{x} \pm s$)3183.39±424.05 3183.69±460.33 0.995 低 4 (3.48) 31 (5.66) 0.342 正常 111 (96.52) 517 (94.34) 6月龄以内喂养方式 0.094 纯母乳喂养 21 (18.26) 134 (24.45) 混合喂养 54 (46.96) 274 (50.00) 人工喂养 40 (34.78) 140 (25.55) 注:括号内数据为百分比,括号外数据例数 表 2 暴露组和对照组婴儿在各时点的低体重、生长迟缓和消瘦发生情况
Table 2. Incidences of underweight, stunting and wasting at different time points in exposure group and control group
项目 1月龄
(n=587)3月龄
(n=263)6月龄
(n=564)12月龄
(n=446)低体重 9 (1.53) 7 (2.66) 7 (1.24) 5 (1.12) 暴露组 1 (0.98) 0 (0.00) 0 (0.00) 0 (0.00) 对照组 8 (1.65) 7 (3.30) 7 (1.51) 5 (1.36) P值 0.955 0.406 0.455 0.650 生长迟缓 26 (4.43) 11 (4.18) 22 (3.90) 16 (3.59) 暴露组 2 (1.96) 0 (0.00) 4 (3.96) 3 (3.80) 对照组 24 (4.95) 11 (5.19) 18 (3.89) 13 (3.54) P值 0.285 0.203 1.000 1.000 消瘦 5 (0.85) 2 (0.76) 4 (0.71) 4 (0.90) 暴露组 3 (2.94) 0 (0.00) 0 (0.00) 0 (0.00) 对照组 2 (0.41) 2 (0.94) 4 (0.86) 4 (1.09) P值 0.053 1.000 0.777 0.784 注:括号内数据为百分比(%),括号外数据为例数(例) 表 3 广义估计方程分析婴儿体格生长发育指标Z分的影响因素
Table 3. Influencing factors of Z scores of infants’ physical growth by Generalized Estimation Equation
因变量 OR值(95%CI) Wald χ2值 P值 年龄别身长Z分 孕期抗病毒治疗(暴露组) 0.585
(0.371~0.923)5.312 0.021 年龄别体重Z分 孕期抗病毒治疗(暴露组) 0.906
(0.528~ 1.553)0.129 0.719 身长别体重Z分 孕期抗病毒治疗(暴露组) 1.352
(0.775~ 2.357)1.129 0.288 注:调整变量有母亲年龄(连续性变量)、职业、户籍、孕产史、HBeAg感染状态、出生胎龄(连续性变量) -
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