乙型肝炎病毒母婴传播预防临床指南(2020)

中华医学会妇产科学分会产科学组; 中华医学会围产医学分会

doi:10.3760/cma.j.cn112141-20200213-00101

乙型肝炎病毒母婴传播预防临床指南(2020)

DOI: 10.3760/cma.j.cn112141-20200213-00101

详细信息

中图分类号: R714.251
计量
- 文章访问数: 958
- HTML全文浏览量: 126
- PDF下载量: 871
- 被引次数: 71
出版历程
- 出版日期: 2020-07-20

2020 clinical guidelines on prevention of mother-to-child transmission of hepatitis B virus

Obstetrics Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Association,
Chinese Society of Perinatal Medicine, Chinese Medical Association

摘要

摘要:
乙型肝炎病毒(HBV)母婴传播是我国慢性乙型肝炎(乙肝)的主要原因,预防HBV母婴传播是控制慢性乙肝的关键。本指南在《乙型肝炎病毒母婴传播预防临床指南(第1版)》基础上,更新了推荐建议,主要包括:(1)所有孕妇产前需筛查乙肝血清学指标;(2) HBsAg阴性母亲,其新生儿按"0、1、6月"方案接种乙肝疫苗,通常不需使用乙肝免疫球蛋白(HBIG);(3) HBsAg阳性母亲,其新生儿出生后12 h内(越快越好)肌内注射1针HBIG,并同时肌内注射第1针乙肝疫苗(越快越好),1月和6月龄分别接种第2针和第3针疫苗;(4)为进一步减少母婴传播,孕妇HBV DNA>2×10~5IU/ml或HBeAg阳性,从妊娠28～32周可开始服用抗病毒药物,分娩当日停药;(5)不推荐以减少HBV母婴传播为目的的剖宫产术。
- 乙型肝炎病毒 /
- 传染性疾病传播,垂直 /
- 免疫预防 /
- 诊疗准则(主题)
Abstract:
Mother-to-child transmission( MTCT) of hepatitis B virus( HBV) is the main cause of chronic hepatitis B( CHB) in China,and the prevention of MTCT plays a critical role in controlling CHB. Based on Clinical guidelines for the prevention of mother-to-child transmission of hepatitis B virus( First Edition) issued in 2013,the current clinical guidelines have updated the recommendations,mainly including:( 1) all pregnant women should undergo the prenatal screening for hepatitis B serological markers;( 2) neonates whose mothers have negative HBsAg should receive hepatitis B vaccination according to the regimen of “0,1,and 6 months”,and there is generally no need for hepatitis B immunoglobulin( HBIG);( 3) neonates whose mothers have positive HBsAg need intramuscular injection of HBIG at one dose and the first dose of hepatitis B vaccine within 12 hours after birth( the sooner the better),followed by injection of the second and third doses of hepatitis B vaccine at the age of 1 and 6 months,respectively;( 4) to further reduce MTCT of HBV,pregnant women with HBV DNA > 2 × 105 IU/ml or with positive HBe Ag may start to take oral antivirals at the 28-32 weeks of gestation until the day of delivery;( 5) cesarean section,with the purpose to reduce MTCT of HBV,is not recommended.
- hepatitis B virus /
- infectious disease transmission,vertical /
- immunoprophylaxis /
- practice guideline as topic

HTML全文

参考文献(46)

[1] Obstetrics Subgroup,Chinese Society of Obstetrics and Gynecology,Chinese Medical Association.Clinical guidelines for the prevention of mother-to-child transmission of hepatitis B virus(First Edition)[J].Chin J Obstetr Gynecol,2013,48(2):151-154.(in Chinese)中华医学会妇产科学分会产科学组．乙型肝炎病毒母婴传播预防临床指南(第1版)[J]．中华妇产科杂志，2013,48(2):151-154．

[2]XU CY,LIU JL,LIU LH,et al.Levels of hepatitis B virus and its antigen in pregnant versus non-pregnant women of childbearing age[J].Chin J Perinatal Med,2015,18(11):828-831.(in Chinese)徐陈瑜，刘景丽，刘兰华，等．妊娠和非妊娠育龄妇女体内乙型肝炎病毒及其抗原水平比较[J]．中华围产医学杂志，2015,18(11):828-831．

[3]LU Y,ZHU FC,LIU JX,et al.The maternal viral threshold for antiviral prophylaxis of perinatal hepatitis B virus transmission in settings with limited resources:A large prospective cohort study in China[J].Vaccine,2017,35(48 Pt B):6627-6633．

[4]LIU JL,LIU LH,XU CY,et al.Limitation of hepatitis B markers in cord blood for diagnosing intrauterine infection of hepatitis B virus[J].Chin J Perinatal Med,2015,18(11):812-817.(in Chinese)刘景丽，刘兰华，徐陈瑜，等．脐血乙型肝炎病毒血清学标记物诊断宫内感染的局限性[J]．中华围产医学杂志，2015,18(11):812-817．

[5]ZHANG L,GUI XE,WANG B,et al.Serological positive markers of hepatitis B virus in femoral venous blood or umbilical cord blood should not be evidence of in-utero infection among neonates[J].BMC Infect Dis,2016,16(1):408．

[6]LIU J,XU B,CHEN T,et al.Presence of hepatitis B virus markers in umbilical cord blood:Exposure to or infection with the virus?[J].Dig Liver Dis,2019,51(6):864-869．

[7]WANG L,KOURTIS AP,ELLINGTON S,et al.Safety of tenofovir during pregnancy for the mother and fetus:A systematic review[J].Clin Infect Dis,2013,57(12):1773-1781．

[8]GILES M,VISVANATHAN K,LEWIN S,et al.Clinical and virological predictors of hepatic flares in pregnant women with chronic hepatitis B[J].Gut,2015,64(11):1810-1815．

[9]YI W,PAN CQ,HAO J,et al.Risk of vertical transmission of hepatitis B after amniocentesis in HBs antigen-positive mothers[J].JHepatol,2014,60(3):523-529．

[10]HAN Z,ZHANG Y,BAI X,et al.Mother-to-child transmission of hepatitis B virus after amniocentesis:A retrospective matched cohort study[J].Prenat Diagn,2019,39(6):431-440．

[11]ZHU YY,MAO YZ,WU WL,et al.Does hepatitis B virus prenatal transmission result in postnatal immunoprophylaxis failure?[J].Clin Vaccine Immunol,2010,17(12):1836-1841．

[12]FENG J,LI J,LIU JL,et al.Influence of amniocentesis on risk of mother-to-child transmission of hepatitis B virus[J].Chin J Perinatal Med,2015,18(11):823-827.(in Chinese)冯静，李洁，刘景丽，等．羊膜腔穿刺对乙型肝炎病毒母婴传播的影响[J]．中华围产医学杂志，2015,18(11):823-827．

[13]HU Y,XU C,XU B,et al.Safety and efficacy of telbivudine in late pregnancy to prevent mother-to-child transmission of hepatitis B virus:A multicenter prospective cohort study[J].J Viral Hepat,2018,25(4):429-437．

[14]JOURDAIN G,NGO-GIANG-HUONG N,HARRISON L,et al.Tenofovir versus placebo to prevent perinatal transmission of hepatitis B[J].N Engl J Med,2018,378(10):911-923．

[15]ZHANG H,PAN CQ,PANG Q,et al.Telbivudine or lamivudine use in late pregnancy safely reduces perinatal transmission of hepatitis Bvirus in real-life practice[J].Hepatology,2014,60(2):468-476．

[16]CHEN HL,LEE CN,CHANG CH,et al.Efficacy of maternal tenofovir disoproxil fumarate in interrupting mother-to-infant transmission of hepatitis B virus[J].Hepatology,2015,62(2):375-386．

[17]PAN CQ,DUAN Z,DAI E,et al.Tenofovir to prevent hepatitis Btransmission in mothers with high viral load[J].N Engl J Med,2016,374(24):2324-2334．

[18]ZENG QL,XU GH,WANG B,et al.Prophylactic antiviral therapy for the prevention of mother-to-child transmission of hepatitis B virus can be stopped at delivery[J].J Viral Hepat,2018,25(5):612-613．

[19]GREENUP AJ,TAN PK,NGUYEN V,et al.Efficacy and safety of tenofovir disoproxil fumarate in pregnancy to prevent perinatal transmission of hepatitis B virus[J].J Hepatol,2014,61(3):502-507．

[20]ZHOU YH,HU YL.Prevention of mother-to-infant transmission of hepatitis B:Advances and challenges[J].Chin J Perinatal Med,2018,21(8):505-509.(in Chinese)周乙华，胡娅莉．我国预防乙型肝炎母婴传播的进展和亟待研究的问题[J]．中华围产医学杂志，2018,21(8):505-509．

[21]European Association for the Study of the Liver.EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection[J].J Hepatol,2017,67(2):370-398．

[22]TERRAULT NA,LOK ASF,Mc MAHON BJ,et al.Update on prevention,diagnosis,and treatment of chronic hepatitis B:AASLD 2018hepatitis B guidance[J].Hepatology,2018,67(4):1560-1599．

[23]CUI FQ,ZHUANG H.Achievements and prospects for preventing mother-to-child transmission of hepatitis B virus in newborns in China[J].Chin J Viral Dis,2019,9(5):321-326.(in Chinese)崔富强，庄辉．我国新生儿乙型肝炎母婴阻断成就和展望[J]．中国病毒病杂志，2019,9(5):321-326．

[24] Chinese Society of Infectious Diseases,Chinese Medical Association;Chinese Society of Hepatology,Chinese Medical Association.Guidelines for the prevention and treatment of chronic hepatitis B(version2019)[J].J Clin Hepatol,2019,35(12):2648-2669.(in Chinese)中华医学会感染病学分会，中华医学会肝病学分会．慢性乙型肝炎防治指南(2019年版)[J]．临床肝胆病杂志，2019,35(12):2648-2669．

[25]CHEUNG KW,SETO M,KAN A,et al.Immunoprophylaxis failure of infants born to hepatitis B carrier mothers following routine vaccination[J].Clin Gastroenterol Hepatol,2018,16(1):144-145．

[26]LOU HQ,ZHU JH,WANG ZH,et al.Real-world efficacy of immunoprophylaxis against mother-to-infant transmission of hepatitis B virus based on puerperant population[J].Chin J Perinatal Med,2019,22(8):591-596.(in Chinese)娄海琴，朱继华，王志红，等．以产妇人群为基础的免疫预防乙型肝炎病毒母婴传播的现实世界效果[J]．中华围产医学杂志，2019,22(8):591-596．

[27]QIAO YP,SU M,SONG Y,et al.Outcomes of the national programme on prevention of mother-to-child transmission of hepatitis Bvirus in China,2016-2017[J].Infect Dis Poverty,2019,8(1):65．

[28]ZHOU YH.Issues meriting further study in preventing mother-to-infant transmission of hepatitis B by antiviral therapy during pregnancy[J].Maternal Fetal Medicine,2019,1(1):43-47．

[29]LIN XQ,HU YL,ZHOU YH.Efficacy and adverse events of nucleos(t)ide analogues in the prevention of perinatal transmission of hepatitis B during pregnancy[J].Chin J Viral Dis,2015,5(3):161-166.(in Chinese)林晓倩，胡娅莉，周乙华．孕期使用核苷(酸)类药物预防乙型肝炎病毒母婴传播的效果和不良事件[J]．中国病毒病杂志，2015,5(3):161-166．

[30]HAN GR,JIANG HX,WANG CM,et al.Long-term safety and efficacy of telbivudine in infants born to mothers treated during the second or third trimesters of pregnancy[J].J Viral Hepat,2017,24(6):514-521．

[31]CHEN ZX,GU GF,BIAN ZL,et al.Clinical course and perinatal transmission of chronic hepatitis B during pregnancy:A real-world prospective cohort study[J].J Infect,2017,75(2):146-154．

[32]WANG R,FANG S,SUN Q,et al.Congenital biliary atresia in an infant born to hepatitis B mother treated with telbivudine before and during pregnancy[J].Dig Liver Dis,2018,50(10):1097-1098．

[33]HE T,BAI Y,CAI H,et al.Safety and efficacy of lamivudine or telbivudine started in early pregnancy for mothers with active chronic hepatitis B[J].Hepatol Int,2018,12(2):118-125．

[34]ZHOU C,YU Y,YANG Q,et al.Motor development delay in offspring is associated with prenatal telbivudine exposure[J].Medicine(Baltimore),2018,97(9):e0053．

[35]KOURTIS AP,WIENER J,WANG L,et al.Tenofovir disoproxil fumarate use during pregnancy and infant bone health:The Tenofovir in pregnancy pilot study[J].Pediatr Infect Dis J,2018,37(11):e264-e268．

[36]PAN CQ,ZOU HB,CHEN Y,et al.Cesarean section reduces perinatal transmission of hepatitis B virus infection from hepatitis B surface antigen-positive women to their infants[J].Clin Gastroenterol Hepatol,2013,11(10):1349-1355．

[37]HU Y,CHEN J,WEN J,et al.Effect of elective cesarean section on the risk of mother-to-child transmission of hepatitis B virus[J].BMC Pregnancy Childbirth,2013,13:119．

[38]CHEN HL,CAI JY,SONG YP,et al.Vaginal delivery and HBVmother to child transmission risk after immunoprophylaxis:A systematic review and a meta-analysis[J].Midwifery,2019,74:116-125．

[39]BRUCE MG,BRUDEN D,HURLBURT D,et al.Antibody levels and protection after hepatitis B vaccine:Results of a 30-year follow-up study and response to a booster dose[J].J Infect Dis,2016,214(1):16-22．

[40]SIMONS BC,SPRADLING PR,BRUDEN DJ,et al.A longitudinal hepatitis B vaccine cohort demonstrates long-lasting hepatitis B virus(HBV)cellular immunity despite loss of antibody against HBV surface antigen[J].J Infect Dis,2016,214(2):273-280．

[41]WEI KP,ZHU FC,LIU JX,et al.The efficacy of two different dosages of hepatitis B immunoglobulin combined with hepatitis B vaccine in preventing mother-to-child transmission of hepatitis B virus:Aprospective cohort study[J].Vaccine,2018,36(2):256-263．

[42]Are booster immunisations needed for lifelong hepatitis B immunity?European Consensus Group on Hepatitis B Immunity[J].Lancet,2000,355(9203):561-565．

[43]ZHAO H,ZHOU YH.Revaccination against hepatitis B in late teenagers who received vaccination during infancy:Yes or no?[J].Hum Vaccin Immunother,2018,14(2):456-463．

[44]ZHOU YH,HU YL.An appropriate dose of hepatitis B immunoglobulin for preventing mother-to-child transmission of hepatitis B:Asingle injection of 100 U[J].Chin J Perinatal Med,2018,21(2):109-111.(in Chinese)周乙华，胡娅莉．预防乙型肝炎母婴传播的乙肝免疫球蛋白合理剂量:100U单次注射[J]．中华围产医学杂志，2018,21(2):109-111．

[45]LIU JL,FENG J,LIN XQ,et al.Characterization of binding capability of human breast milk to hepatitis B surface antigen[J].Chin JPerinatal Med,2016,19(2):114-118.(in Chinese)刘景丽，冯静，林晓倩，等．母乳与乙型肝炎表面抗原的结合特性[J]．中华围产医学杂志，2016,19(2):114-118．

[46]ZHANG SP,LIU JL,FENG J,et al.Screening and identification of hepatitis B surface antigen binding to lactoferrin in human milk[J].Chin J Perinatal Med,2019,22(7):457-460.(in Chinese)张昭萍，刘景丽，冯静，等．乙型肝炎表面抗原结合人乳中乳铁蛋白的筛选与鉴定[J]．中华围产医学杂志，2019,22(7):457-460.

施引文献

期刊类型引用(53)

1.	陈绍丽，彭淋，别智敏，陈文静，吴智铎，林瑞彬，蔡碧兰，尹乐华，张巧利. 东莞市儿童家长乙肝及乙肝疫苗接种知识知晓情况及其影响因素分析. 中国健康教育. 2025(02): 172-175+180 . 百度学术
2.	唐林，许侠，周泽玫，王晓琪，李继贞，尹遵栋，王富珍. 中国乙型肝炎疫苗免疫策略及接种进展. 临床肝胆病杂志. 2025(02): 210-215 . 本站查看
3.	张颖，姚添，李雁笛，王惠鑫，渠轶群，汪波，李锐，丰淑英，王素萍，冯永亮. 乙型肝炎表面抗原阳性母亲乙型肝炎病毒DNA载量和婴儿出生时MAVS信号通路对婴儿接种乙型肝炎疫苗无/弱应答的影响. 中国疫苗和免疫. 2024(01): 12-18 . 百度学术
4.	赵阳，王玉茹，夏萍，方爽，马福成，金芳多，赵臣. 妊娠期慢性乙型肝炎抗病毒治疗现状及展望. 吉林医药学院学报. 2024(02): 131-135 . 百度学术
5.	刘耀丹，刘敏. 接受母婴阻断治疗的慢性HBV感染孕妇产后肝炎发作的风险预测模型构建. 现代妇产科进展. 2024(03): 196-200+204 . 百度学术
6.	金鑫，彭睿，高玲玲，周文杰. 乙型肝炎病毒母婴传播机制及阻断策略研究进展. 实用临床医药杂志. 2024(04): 140-144 . 百度学术
7.	李倩睿，唐娟，张永男，丁祎，张觅，孙丽洲. 妊娠合并乙肝病毒感染患者血清DNMT1、TIM-3与HBV-DNA病毒载量和妊娠结局的关系分析. 现代生物医学进展. 2024(04): 656-660+728 . 百度学术
8.	杨敏，李红梅，张雷，何流，邓强，江海燕. HBV高载量孕妇孕期抗病毒治疗结合标准阻断措施阻断母婴传播效果. 中国计划生育学杂志. 2024(05): 1153-1157 . 百度学术
9.	于利华，岳艳丽，樊丹丹. 基于IMB模型的多样性心理干预对乙肝病毒携带者产妇产后母乳喂养行为、产后抑郁及育儿胜任感的影响. 黑龙江医药科学. 2024(03): 130-132 . 百度学术
10.	贾艳萍，王桂云，祁艳霞，徐雁，王君芝，褚梁梁，傅雁南，吴育红，韩孝萱. 围产期乙肝病毒母婴传播阻断的研究进展. 临床护理杂志. 2024(03): 52-55 . 百度学术
11.	赵薇，白文佩. 小剂量阿司匹林预防慢性HBV感染孕妇子痫前期和改善妊娠结局的作用研究. 解放军医学院学报. 2024(05): 475-480 . 百度学术
12.	刘雅菲，李颖，程千吉，黄嘉杰，李盛，葛龙. 基于临床实践指南/专家共识的乙型肝炎预防策略知识图谱构建. 兰州大学学报(医学版). 2024(07): 60-72 . 百度学术
13.	董媛媛，李磊，李昭，虎文祥，马莉. 妊娠合并慢性乙型肝炎患者乙肝标志物、前S1抗原与HBV-DNA的关系研究. 临床医学研究与实践. 2024(28): 27-30 . 百度学术
14.	朱月英. 替诺福韦酯治疗妊娠慢性乙肝对孕妇肝功能及分娩结局的影响. 中国初级卫生保健. 2024(10): 108-110 . 百度学术
15.	杨天卓，李艳丽，王俊，李好，欧阳夕颜，高晗. 血清25-(OH)D3、sVCAM-1、MMP-9与慢性乙型肝炎病毒感染孕妇合并妊娠期肝内胆汁淤积症的关系研究. 现代生物医学进展. 2024(20): 3987-3989 . 百度学术
16.	焦放，杨大为，岳欣，曹慧，纪亚亮，许青云. 替诺福韦对乙型肝炎母婴阻断的成本-效果分析. 河北医科大学学报. 2024(11): 1336-1341 . 百度学术
17.	黄蓉，祁文瑾. 妊娠合并乙肝的管理. 中国计划生育和妇产科. 2024(11): 9-11 . 百度学术
18.	傅晓华. 感染性疾病与辅助生殖技术. 中国计划生育和妇产科. 2024(11): 23-25 . 百度学术
19.	任先云，高淑敏，康慧杰，刘智睿，杨爽，郁龙飞，包乾君，乌云桑，张瑶. 呼和浩特市2021年出生儿童首剂次乙型肝炎疫苗未及时接种影响因素的病例对照研究. 中国疫苗和免疫. 2024(06): 666-670 . 百度学术
20.	肖琛月，孙果，刘禹涵，李梅. HBV DNA载量和血清学标志物在儿童乙型肝炎防控中的应用价值. 临床检验杂志. 2024(12): 892-896 . 百度学术
21.	任先云，高淑敏，康慧杰，杨爽，乌云桑，张瑶，郁龙飞，包乾君，刘智睿. 呼和浩特市产科门诊医务人员乙肝防治知识、态度和行为调查分析. 疾病监测与控制. 2024(06): 434-437 . 百度学术
22.	王瑶，张欢，潘璠，陈亚飞，张夏晴，邵灵，程凯，马冰欣，秦伟. HBsAg阳性母亲所生低体重儿HBV感染及抗体水平调查. 国际生物制品学杂志. 2024(06): 378-383 . 百度学术
23.	宋玉文，沙丽丽，陈立震，李梦昆，王玉荣，辛永宁. 富马酸丙酚替诺福韦治疗特殊慢性乙型肝炎的相关进展. 临床肝胆病杂志. 2023(01): 156-161 . 本站查看
24.	葛春燕，尤春霞，王晓燕. 乙肝孕期母婴阻断治疗孕产妇产后不同时间停药对肝功能的影响. 齐齐哈尔医学院学报. 2023(07): 635-640 . 百度学术
25.	李威，康艳红，张江峰，殷辉，刘俊平，李玉魁，康谊. 河南省18岁及以下住院患者HBV血清流行病学特征分析. 临床肝胆病杂志. 2023(05): 1056-1060 . 本站查看
26.	赖昕，刘岁寒，杜玉开，彭松绪. 乙型肝炎病毒感染孕妇剖宫产现状及其影响因素分析. 中国生育健康杂志. 2023(05): 466-471 . 百度学术
27.	芮执平，张丽娜，刘武. 甘肃省靖远县住院分娩孕产妇乙型肝炎检测现况及分娩方式分析. 疾病预防控制通报. 2023(04): 1-5 . 百度学术
28.	李力，刘小利，程蔚蔚，苟文丽. 备孕保健专家共识（2023）. 中国优生与遗传杂志. 2023(09): 1737-1743 . 百度学术
29.	邓雯，蒋婷婷，王诗雨，毕潇月，杨柳，林妍洁，张璐，路遥，易为，谢尧，李明慧. 乙型肝炎病毒母婴阻断策略. 病毒学报. 2023(05): 1405-1413 . 百度学术
30.	贾再明，王翠敏. 乙型肝炎病毒母婴传播阻断的研究进展与展望. 大医生. 2023(20): 140-144 . 百度学术
31.	李丽，胥文敏，赵睿，马小雨，李红梅. HLA-DPβ1表达水平与乙型肝炎病毒母婴传播阻断效果的关系研究. 延安大学学报(医学科学版). 2023(04): 54-58+67 . 百度学术
32.	张玉蓉，彭孟云，尹玥，汪静. 替诺福韦酯阻断乙肝母婴传播的疗效评价. 西南医科大学学报. 2022(02): 131-134 . 百度学术
33.	关丽芬，邱翠青. 乙型肝炎孕妇大小三阳状态对妊娠结局的影响. 检验医学与临床. 2022(07): 956-958 . 百度学术
34.	钟璐，牙程玉，严惠萍，李亚芹，吕超，张荣臻. 慢性HBV感染的妊娠期妇女使用替诺福韦酯的疗效及安全性观察. 广西中医药大学学报. 2022(03): 5-9 . 百度学术
35.	姜先杏，洪永孟，陈兴. 替诺福韦酯联合双重免疫方案阻断慢性乙型肝炎病毒携带孕妇母婴病毒传播的临床效果. 中国当代医药. 2022(17): 66-69 . 百度学术
36.	张竑，沈敏，郑雅宁，张媛媛，王芬，徐凤娟. 团队资源管理在乙肝母亲的新生儿预防接种中的应用及效果观察. 护士进修杂志. 2022(16): 1508-1512 . 百度学术
37.	葛翠翠，尹亚童，江敏，袁丽. 2017-2021年青岛市预防艾滋病、梅毒和乙型病毒性肝炎母婴传播动态观察效果分析. 新发传染病电子杂志. 2022(03): 64-67 . 百度学术
38.	陈婷婷，王涛，叶峻杰，孙丽娟，杜应雄，陈涓涓，张云，叶汉风. 2010—2019年云南省农村育龄女性乙型肝炎病毒血清学筛查结果分析. 中国预防医学杂志. 2022(09): 652-657 . 百度学术
39.	方建凯，李孝楼，江晓燕，罗琼. 慢性乙型肝炎住院患者近5年的构成比分析. 福建医药杂志. 2022(05): 84-86 . 百度学术
40.	李兆明，邹美银，张丽，明芳. 妊娠合并慢性乙型肝炎肝功能指标变化与母儿并发症相关性的临床研究. 南通大学学报(医学版). 2022(04): 380-384 . 百度学术
41.	曾晓岚，李淑玲，向冬梅，陈沛颖，潘红英，叶艳贞. 不同乙肝高病毒载量孕妇使用替诺福韦不同时期HBV-DNA变化情况分析. 标记免疫分析与临床. 2022(09): 1455-1459 . 百度学术
42.	赵沛，陈一凡，刘文斌，方乐天，余红平，曹广文. 乙肝病毒致癌主要机制. 上海预防医学. 2022(10): 1058-1064 . 百度学术
43.	梁琼文，周正银，韦丽，黄元娇. 乙肝病毒载量对妊娠期糖尿病的影响研究. 实用妇科内分泌电子杂志. 2022(14): 1-3 . 百度学术
44.	王保旭，白桂芹. 妊娠合并原发性肝癌3例临床分析及文献复习. 中国妇幼健康研究. 2021(03): 459-464 . 百度学术
45.	肖鹏，巴桃桃，丁梦梦，高沿航. 妊娠期肝病临床研究进展. 临床肝胆病杂志. 2021(05): 1229-1232 . 本站查看
46.	马晓鹏，刘华仙，朱云霞. 孕期富马酸替诺福韦二吡呋酯抗病毒治疗对孕妇骨代谢及新生儿骨密度的影响. 中国肝脏病杂志(电子版). 2021(02): 34-39 . 百度学术
47.	张玉玺，吴冰冰，左志平，纪磊，魏鹏飞，成贝贝，梁娟. 乙型肝炎表面抗原阳性母亲所生早产儿和低体重儿4剂次乙型肝炎疫苗和第1剂疫苗与乙型肝炎免疫球蛋白联合免疫的免疫原性. 中国疫苗和免疫. 2021(05): 504-508 . 百度学术
48.	朱博，冯福民，戴二黑. HBV母婴传播现状及预防策略研究新进展. 传染病信息. 2021(05): 473-477 . 百度学术
49.	吴炜林，王睿，王润，芮婷婷，曹臻，陶庆. 芜湖市乙肝免疫球蛋白与乙肝疫苗联合免疫阻断乙肝病毒母婴传播效果评价. 安徽预防医学杂志. 2021(05): 374-376+398 . 百度学术
50.	吴霞，张玉蓉，汪静. 妊娠期抗乙肝病毒药物使用指南争议性问题的总结和比较. 西南医科大学学报. 2021(06): 681-685 . 百度学术
51.	徐陈瑜，徐娟. 妊娠合并乙型肝炎病毒感染研究进展. 中国临床研究. 2021(11): 1561-1564 . 百度学术
52.	阻断乙型肝炎病毒母婴传播临床管理流程(2021年). 临床肝胆病杂志. 2021(03): 527-531 . 本站查看
53.	孙传名，周荣生，吴艳. CD209/CD209L基因多态性在乙型肝炎病毒阳性孕妇中表达及其与胎盘Toll样受体3相关性. 临床军医杂志. 2020(09): 1074-1075+1078 . 百度学术