Meta analysis of the effect of hepatitis B immunoglobulin combined with hepatitis B vaccines on interrupting intrauterine transmission of HBV.

2010 
[Objective] To evaluate systematically the validity of injection of hepatitis B immunoglobulin(HBIG)during the third trimester of pregnancy combined with injection of HBIG and hepatitis B vaccines for neonates on interrupting intrauterine transmission of HBV,and to provide the evidence-based basis for establishing the strategy of HBV vaccination for key population.[Methods] Related literatures were searched using computer.Altogether 66 related papers had been retrieved,but only 8 of them were included into this analysis,in which the intervention of experimental group was treating with injection of HBIG during the third trimester of pregnancy and combined with injection of HBIG and hepatitis B vaccine for their neonates,whereas the intervention of control group was treating with injection of hepatitis B vaccine only for neonates.Fixed and random effect models were applied to finish the Meta analysis for the 8 randomized control studies which conformed to the included criterion.[Results] The publishing error of these included studies was comparatively small.The results of Meta analysis showed the rate of intrauterine transmission of experimental group(6.01%)was lower than that of control group(16.37%)with χ2 =7.02(P 0.001)and the total RR =0.37(95%CI:0.28-0.48).The sensitivity analysis suggested the stability of the model was good.The analysis of subcategory showed,whether for those simply with HBsAg positive or those with both HBsAg and HBeAg positive,either,whether regarding the sign of HBV infection positive within 24 hours after birth as standard or regarding the sign of HBV infection positive 12 months after birth as standard,the rates of intrauterine transmission of experimental group were both lower than those of control group with statistical significance(P 0.05).[Conclusion] Injection of HBIG during the third trimester of pregnancy combined with injection of HBIG and hepatitis B vaccines for their neonates could effectively interrupt the intrauterine transmission of HBV.
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