宁波市2015-2017年新生儿首剂乙型肝炎疫苗及时接种的影响因素
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摘要
目的分析宁波市新生儿首剂乙型肝炎疫苗(HepB)及时接种的影响因素。方法选择宁波市产科预防接种信息系统登记的2015-2017年出生的新生儿,收集首剂HepB(HepB1)接种和相关因素信息,采用Logistic回归和相关性分析方法分析HepB1及时(HepB1t)接种率的影响因素。结果 2015-2017年196 576名新生儿总HepB1t接种率为93.61%;其中2015年、2016年、2017年分别为94.96%、94.19%、92.11%。男性(OR=0.81,95%C I:0.76-0.87)、城区医院出生(OR=0.62,95%C I:0.57-0.67)、低出生体重(OR=0.04,95%C I:0.03-0.04)、出生胎次≥2(OR=0.79,95%CI:0.74-0.84)、≥35岁高龄产妇(OR=0.63,95%CI:0.58-0.69)与新生儿低HepB1t接种率有关。分月新生儿HepB1t接种率与产妇平均年龄、高龄产妇比例、低出生体重新生儿比例、≥2胎次新生儿比例、城区医院新生儿比例之间均呈负相关(r=-0.84,P<0.01;r=-0.87,P<0.01;r=-0.42,P=0.01;r=-0.78,P<0.01;r=-0.59,P<0.01)。结论 2015-2017年宁波市新生儿HepB1t接种率有所降低,与产妇年龄高、胎次增加、低出生体重新生儿比例上升有关。
Objective To determine factors influencing timely vaccination with the first dose of hepatitis B vaccine(HepB) among newborns in Ningbo city. Methods We identified newborns who were born in 2015-2017 and registered through the Ningbo Obstetric Neonatal Immunization Information System, and determined factors influencing the coverage rate of a timely first-dose of HepB(HepB1 t) using logistic regression and correlation analysis. Results Overall HepB1 t coverage was 93.61% among 196 576 newborns in2015-2017, with coverage levels of 94.96%, 94.19% and 92.11% in 2015, 2016, and 2017. Male newborns(OR=0.81, 95%CI: 0.76-0.87),urban birth hospital(OR=0.62, 95%CI: 0.57-0.67), low birth weight(OR=0.04, 95%CI: 0.03-0.04), ≥2 birth parity(OR=0.79, 95%CI:0.74-0.84), and maternal age over 35 years(OR=0.63, 95%CI: 0.58-0.69)were significantly associated with the low HepB1 t coverage.Monthly HepB1 t coverage among newborns was negatively correlated with average maternal age, the proportion of mothers over 35 years, the proportion of low-birth-weight newborns, the proportion of women with parity of two or more, and the proportion of newborns born in an urban hospital(r=-0.84, P<0.01; r=-0.87, P<0.01; r=-0.42, P=0.01;r=-0.78, P<0.01; r=-0.59, P<0.01). Conclusions HepB1 t coverage of newborns declined during 2015-2017 in Ningbo, and was influenced by the proportion of mothers over 35 years of age, increasing parity, and low birth weight.
Objective To determine factors influencing timely vaccination with the first dose of hepatitis B vaccine(HepB) among newborns in Ningbo city. Methods We identified newborns who were born in 2015-2017 and registered through the Ningbo Obstetric Neonatal Immunization Information System, and determined factors influencing the coverage rate of a timely first-dose of HepB(HepB1 t) using logistic regression and correlation analysis. Results Overall HepB1 t coverage was 93.61% among 196 576 newborns in2015-2017, with coverage levels of 94.96%, 94.19% and 92.11% in 2015, 2016, and 2017. Male newborns(OR=0.81, 95%CI: 0.76-0.87),urban birth hospital(OR=0.62, 95%CI: 0.57-0.67), low birth weight(OR=0.04, 95%CI: 0.03-0.04), ≥2 birth parity(OR=0.79, 95%CI:0.74-0.84), and maternal age over 35 years(OR=0.63, 95%CI: 0.58-0.69)were significantly associated with the low HepB1 t coverage.Monthly HepB1 t coverage among newborns was negatively correlated with average maternal age, the proportion of mothers over 35 years, the proportion of low-birth-weight newborns, the proportion of women with parity of two or more, and the proportion of newborns born in an urban hospital(r=-0.84, P<0.01; r=-0.87, P<0.01; r=-0.42, P=0.01;r=-0.78, P<0.01; r=-0.59, P<0.01). Conclusions HepB1 t coverage of newborns declined during 2015-2017 in Ningbo, and was influenced by the proportion of mothers over 35 years of age, increasing parity, and low birth weight.
引文
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[2]EVANS AA,COHEN C,HUANG P,et al.Prevention of perinatal hepatitis B t ransmission in Haimen city,China:results of a community public health initiative[J].Vaccine,2015,33(26):3010-3015.
[3]NELSON NP,JAMIESON DJ,MURPHY TV.Prevention of perinatal hepatitis B virus transmission[J].J Pediatric Infect Dis Soc,2014,3(Suppl 1):S7-12.
[4]ZHANG L,KO S,LV J,et al.Per inatal hepat i t is Bprevent ion program in Shandong province,China:evaluation and progress[J].Human Vaccines&Immunotherapeutics,2014,10(9):2755-2760.
[5]王富珍,张国民,沈立萍,等.中国1~4岁儿童首针乙型肝炎疫苗未及时接种者特征及影响因素分析[J].中华流行病学杂志,2017,38(1):32-36.WANG Fuzhen,ZHANG Guomin,SHEN Liping,et al.Epidemiological character ist ics of children aged 1-4years without timely birth dose of hepatitis B vaccine vaccinat ion in China,2014[J].Chinese Journal of Epidemiology,2017,38(1):32-36.
[6]崔健,曹雷,郑景山,等.中国2015年国家免疫规划疫苗报告接种率分析[J].中国疫苗和免疫,2017,23(6):601-607.CUI Jian,CAO Lei,ZHENG Jingshan,et al.Reported coverage of vaccines in the Nat ional Immunizat ion Program of China,2015[J].Chinese Journal of Vaccines and Immunization,2017,23(6):601-607.
[7]SCHILLIE S,WALKER T,VESELSKY S,et al.Outcomes ofinfants born to women infected with hepatitis B[J].Pediatrics,2015,135(5):e1141-1147.
[8]STEVENS CE,TOY P,KAMILI S,et al.Eradicat ing hepatitis B virus:the critical role of preventing perinatal transmission[J].Biologicals,2017,50:3-19.
[9]马小军,王富珍,郑徽,等.青海省孕妇乙型病毒性肝炎产前筛查及母婴传播阻断现况调查[J].中国疫苗和免疫,2017,23(2):148-151.MA Xiaojun,WANG Fuzhen,ZHENG Hui,et al.Prenatal screening of hepatitis B and the status of preventing mother-to-child t ransmission of hepat i t is B vi rus in Qinghai province[J].Chinese Journal of Vaccines and Immunization,2017,23(2):148-151.
[10]王涛,蔡毅媛,刘铭,等.贵阳市医院出生新生儿乙型肝炎疫苗首针未及时接种原因调查分析[J].疾病监测与控制,2015,9(8):533-535.WANG Tao,CAI Yiyuan,LIU Ming,et al.Analysis the reason of unvaccinated first dose hepatitis B vaccine to the neonates delivered in hospital in Guiyang[J].Journal of Diseases Monitor&Control,2015,9(8):533-535.
[11]王睁,李利,雷雪丫,等.产妇高龄对新生儿出生缺陷及生后并发症的影响[J].中国当代儿科杂志,2016,18(11):1084-1089.WANG Zheng,LI Li,LEI Xueya,et al.Effect of advanced maternal age on birth defects and postnatal complications of neona tes[J].Chinese Journal of Contempora ry Pediatrics,2016,18(11):1084-1089.
[12]刘军防,尚延慧,张巧玲.低出生体重儿的发生情况及相关因素调查[J].中华全科医学,2013,11(2):274+311.LIU Junfang,SHANG Yanhui,ZHANG Qiaoling.Investigation on the incidence and the related factors oflow birth weight infants[J].Chinese Journal of General Practice,2013,11(2):274+311.
[13]赵薛飞,方挺,董红军,等.基于HIS系统的产科预防接种信息系统的建设与应用[J].中国卫生信息管理杂志,2017,14(6):858-861.ZHAO Xuef ei,FANG Ting,DONG Hong jun,et al.Const ruct ion and appl icat ion of obst e t r ic neonatal immunizat ion inf ormat ion system based on HIS[J].Chinese Journal of Health Informatics and Management,2017,14(6):858-861.