European Journal of Pediatrics

, Volume 173, Issue 9, pp 1161–1168 | Cite as

A study of immunoprophylaxis failure and risk factors of hepatitis B virus mother-to-infant transmission

  • Lei Zhang
  • Xien GuiEmail author
  • Bo Wang
  • Huiping Ji
  • Reziyan Yisilafu
  • Fengliang Li
  • Yun Zhou
  • Ling Zhang
  • Hui Zhang
  • Xiaohong Liu
Original Article


Hepatitis B virus (HBV) infection is of high prevalence in China. Mother-to-infant transmission is the major route for HBV transmission and subsequent chronicity. This study aimed to investigate current HBsAg-positive rate among pregnant women and immunoprophylaxis outcome in China. Multicenter prospective study was conducted in 10 centers. From 2008 to 2012, 67,720 pregnant women were screened and 1,150 HBsAg-carrier mothers and their infants aged 8–12 months were studied in four out of all centers, among whom HBV markers (HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb) and HBV DNA (in three centers) were measured. The results showed that HBsAg-positive rate of pregnant women was 6.7 % (4,533/67,720) and infants’ immunoprophylaxis failure rate was 3.4 % (39/1,150). Immunoprophylaxis failure infants were all born to mothers of HBeAg-positive and HBV DNA ≥6 log10 copies/ml. Among infants of HBeAg-positive mothers, multivariable analyses showed the following: mother’s age <28 years vs ≥28 years, RR = 0.157, 95 % confidence interval (CI) [0.067, 0.369], p = 0.000; Neonates receiving vaccine vs vaccine plus hepatitis B immune globulin (HBIG), RR = 0.371, 95 % CI [0.167, 0.825], p = 0.015. Pregnant women receiving HBIG in the third trimester, vaginal delivery and breastfeeding had no significant effects on HBV mother-to-infant transmission. Conclusions: Pregnant women are still of high HBsAg prevalence in China. HBV mother-to-infant transmission still occurs after passive-active immunization. Pregnant women of high HBV replication levels are the major risk population of HBV mother-to-infant transmission. Passive-active immunization is necessary for neonates of HBeAg-positive mothers. Mother’s age <28 years and neonate receiving vaccine only were the risk factors for HBV mother-to-infant transmission. Breastfeeding did not put children at risk of mother-to-infant transmission.


Hepatitis B virus HBV marker Pregnant women Mother-to-infant transmission Immunoprophylaxis failure Risk factor 



Hepatitis B immune globulin

HB vaccine

Hepatitis B vaccine


Hepatitis B virus


Mother-to-child transmission



This study has received research funding from Hong Kong Zeshan Foundation (No. 303235807).

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Lei Zhang
    • 1
  • Xien Gui
    • 1
    • 10
    Email author
  • Bo Wang
    • 2
  • Huiping Ji
    • 3
  • Reziyan Yisilafu
    • 4
  • Fengliang Li
    • 5
  • Yun Zhou
    • 6
  • Ling Zhang
    • 7
  • Hui Zhang
    • 8
  • Xiaohong Liu
    • 9
  1. 1.Department of Infectious DiseasesZhongnan Hospital of Wuhan UniversityWuhanChina
  2. 2.Infectious Disease Hospital of Taiyuan City in Shanxi provinceTaiyuanChina
  3. 3.Mother and Child Hospital of Taishan City in Guangdong provinceTaishanChina
  4. 4.Mother and Child Hospital of Yining City in Xinjiang Uygur Antonomous RegionYiningChina
  5. 5.Mother and Child Hospital of Tongcheng County in Hubei ProvinceTongchengChina
  6. 6.Mother and Child Hospital of Dangyang City in Hubei ProvinceDangyangChina
  7. 7.Mother and Child Hospital of Huanggang City in Hubei ProvinceHuanggangChina
  8. 8.Mother and Child Hospital of Xiaonan District Xiaogan City in Hubei ProvinceXiaoganChina
  9. 9.Mother and Child Hospital of Daye City in Hubei ProvinceDayeChina
  10. 10.Wuhan CityChina

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