Hepatitis B Virus Infection in Preconception Period Among Women of Reproductive Age in Rural China - A Nationwide Study.

Abstract

Hepatitis B virus (HBV) infection during pregnancy is associated with perinatal complications and poor maternal and fetal outcomes. There is a lack of reports on HBV infection screening, prophylaxis, and/or treatment in preconception period among women planning a pregnancy. This study is to investigate the prevalence and demographic characteristics of HBV infection among rural women of reproductive age planning pregnancy within 6 months, in different geographical regions of China. A population-based, cross-sectional, sero-survey of HBV infection among women intending to get pregnant within 6 months was carried out as a part of the National Free Preconception Health Examination Project covering 31 provinces in mainland China between 2010-12. General information (age, residence status, race, education, and occupation), HBV infection and vaccination history was collected. Results of HBV serological test panel were recorded for analysis. Of 2 120 131 women, 2 028 361 (95.7%) samples of HBV serology were available for analysis. Participating women were of young age (median 28.1 years), mostly engaged in agricultural activities (78.1%), and had high school education or lower (89.6%). The overall prevalence of HBsAg sero-positivity was 4.9%, which corresponds to an intermediate epidemic, with a wide geographical variation that ranged from 1.1% in Shanxi to 13.0% in Tibet. 90.1% women were susceptible to HBV with a 24.5% self-reported HBV vaccination rate. Significant regional differences in HBV prevalence, and a vast majority of women of childbearing age being susceptible to HBV, calls for a targeted HBV screening and vaccination strategy for women and their offspring in rural China.