Objective: To explore the influencing factors of mother-to-child transmission of hepatitis B virus (HBV) combined immunization and the changes in the immune response rate of newborns delivered by HBsAg positivemothers.Methods: The clinical data of 1 303 HBsAg positivemothers who were treated and delivered at the Yan'an University Affiliated Hospital from January 2009 to December 2016 and 1 311 children delivered were collected. Multivariate analysis of variance and Logistic regression were used to analyze the lateral data. The factors that affected mother-to-child transmission were studiedandtheir children were called back to test the level of hepatitis B virus serologic marker(HBVM) by chemiluminescence microparticle immunoassay(CMIA). In addition, The fluctuations of serological test in childrenof different ages were compared longitudinally. Results: Twenty-two children were positive for HBsAg, and the success rate of mother-to-child blocking was 97.66% (918/940). The post-vaccination serological testing(PVST) intervalwas 2 to 9 years,and the positive rates of anti-HBs in children were 0.96%, 0.92%, 0.94%, 0.86%, 0.83%, 0.78%, 0.70%, and 0.78%. With the prolongation of the PVST interval, the non-response rate and low-response rate of newborns and children delivered by HBV mothers gradually increased, and the medium-response rate and high-response rate gradually decreased. Quantitative HBsAg of mother (OR=1.414 95% CI 0.000~7.223,P=0.015), quantitative HBeAg of mother(OR=4.341 95% CI 0.001~30.012 P=0.041), HBV DNA copy number of mother(OR=21.202 95% CI 3.005~51.380,P=0.003) and the number of sexual intercourse during the second trimester of pregnancy (OR=7.795 95%,CI 3.135~19.385,P=0.000)were risk factors for mother-to-child transmission(MTCT). Maternal age, parity, whether to inject HBIG during pregnancy, and to havepremature rupture of membranes, mode of delivery, a first-degree family member with HBV, neonatal sex, neonatal weight, feeding method were not related the failure of maternal and infant block. Conclusion: HBsAg quantification, HBeAg quantification, HBV DNA levels of mothers and the number of sexual intercourse during the second trimester of pregnancy are the factors that increase the chances of MTCT. Therefore, giving good counseling and corresponding interventions to them during pregnancy can effectively reduce MTCT. Promoting the implementation of PVST actively can identify children with weak antibody titers or no antibodies early, and provide timely reinoculation vaccines and follow-up.
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