HBeAg阳性孕妇乙型肝炎知晓率现况及抗病毒治疗影响因素分析-东南大学学报医学版

HBeAg阳性孕妇乙型肝炎知晓率现况及抗病毒治疗影响因素分析

作者：孔泉¹ 陈肖肖¹ 钱姣¹ 2 何楚¹ 2 黄钰¹ 詹沈澳³ 姜洁¹ 2 翟祥军¹ 2

单位：1. 南京医科大学公共卫生学院, 江苏南京 211166;
2. 江苏省疾病预防控制中心重大项目办公室, 江苏南京 210009;
3. 东南大学公共卫生学院, 江苏南京 210009

分类号：R183.9;R512.62

出版年·卷·期（页码）：2025·44·第二期（212-220）

摘要：

目的:了解苏北3区县乙肝e抗原(HBeAg)阳性孕妇乙肝相关知识的知晓率和抗病毒治疗率,并探索抗病毒治疗的影响因素。方法:在苏北3区县招募2021年1月1日至2023年12月31日期间分娩的HBeAg阳性孕妇作为调查对象进行问卷调查。采用方差分析比较不同特征孕妇乙肝相关知识知晓得分的差异,采用卡方检验和Logistics回归模型分析影响HBeAg阳性孕妇孕期抗病毒治疗的因素。结果:收集有效问卷244份,调查对象的乙肝相关知识知晓率为77.96%,其中受教育程度高者、孕期进行抗病毒治疗者具有较高的得分,差异有统计学意义(P<0.05)。调查地区HBeAg阳性孕妇抗病毒治疗率为59.02%,多因素Logistics回归分析结果显示,与文化程度为初中及以下的HBeAg阳性孕妇相比,拥有大专及以上学历的孕妇孕期抗病毒治疗率较高(OR=2.25,95%CI 1.11~4.56);与孕前未就诊的HBeAg阳性孕妇相比,孕前就诊的孕妇孕期抗病毒治疗率较高(OR=1.98,95%CI 1.14~3.44);与孕前未行抗病毒治疗的HBeAg孕妇相比,孕前行抗病毒治疗的孕妇孕期抗病毒治疗率高(OR=8.57,95%CI 3.38~21.74);与HBV相关知识知晓低分组相比,HBV相关知识知晓高分组的HBeAg阳性孕妇抗病毒治疗率较高(OR=2.13,95%CI 1.09~4.20);与在省市级医疗机构进行产前检查的HBeAg阳性孕妇相比,在乡镇卫生院或社区卫生服务中心进行产前检查的孕妇抗病毒治疗率较低(OR=0.25,95%CI 0.07~0.91)。结论:苏北地区HBeAg阳性孕妇乙肝相关知识知晓率总体较高,但认识不全面,抗病毒治疗率处于中上水平。应加大乙肝传播途径的宣传,加强医务人员乙肝防治策略的培训,增加基层医疗机构的资源倾斜,从而提高目标人群对于乙肝防治措施的知晓率和抗病毒治疗率。

Objective: To investigate the knowledge awareness rate of HBeAg-positive pregnant women about hepatitis B and the rate of antiviral therapy in three counties in northern Jiangsu Province, and to explore the factors affecting antiviral therapy. Methods: HBeAg-positive pregnant women who gave birth between January 1, 2021 and December 31, 2023 in three counties of northern Jiangsu Province was recruited as investigation subjects for a questionnaire survey. ANOVA was employed to compare the differences in hepatitis B-related knowledge awareness scores among various groups. Chi-square tests and Logistic regression models were utilized to examine the factors influencing antiviral therapy during pregnancy in HBeAg-positive women. Results: A total of 244 valid questionnaires were collected. The HBV-related knowledge awareness rate among the participants was 77.96%. Notably, those with higher levels of education and those who received antiviral therapy during pregnancy achieved significantly higher scores(P<0.05). The antiviral therapy rate among HBeAg-positive pregnant women in the study area was 59.02%. Multivariate analysis revealed several factors influencing antiviral therapy rates during pregnancy: compared to women with an education level of junior high school or below, those with a college degree or above had a higher antiviral therapy rate(OR=2.25, 95% CI 1.11-4.56); compared to women who had not sought medical consultation before pregnancy, those who had pre-pregnancy consultations were more likely to receive antiviral therapy(OR=1.98, 95% CI 1.14-3.44); women who received antiviral therapy before pregnancy were significantly more likely to receive antiviral therapy during pregnancy, compared to those who did not(OR=8.57, 95% CI 3.38-21.74); women with higher HBV-related knowledge were more likely to receive antiviral therapy than those with lower knowledge(OR=2.13, 95% CI 1.09-4.20); and women who received prenatal care at township health centers or community clinics had a lower antiviral treatment rate than those receiving care at provincial or municipal healthcare institutions(OR=0.25, 95% CI 0.07-0.91). Conclusion: The HBV-related knowledge awareness rate among HBeAg-positive pregnant women in northern Jiangsu Province is generally high but remains incomplete. The antiviral therapy rate is at a moderate to high level. To enhance hepatitis B prevention and control, it is imperative to increase public awareness of hepatitis B transmission routes, strengthen the training of medical staff on hepatitis B prevention strategies, and allocate more resources to primary care organizations. These measures will help improve the target population's knowledge awareness of hepatitis B prevention and increase antiviral therapy rates.

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