Objective To investigate the risk factors of intrauterine hepatitis B virus (HBV)infection and its preventive measures.Methods 254 cases of pregnant women with positive HBsAg and their neonatuses from Shaanxi People’s Hospi-tal were selected as the research object.The serum of pregnant women were tested HBV markers and HBV-DNA,their neo-natal umbilical cord blood were only detected HBV markers.Results In 254 samples,the positive rates of HBsAg and HBeAg within their neonatal umbilical cord blood were 5.12% and 13.78% respectively;the positive rate of HBV infection in neonatal umbilical cord blood among maternal HBeAg-positive group was 53.33%,far higher than 3.61% in HBeAg-neg-ative group (χ2 =99.44,P <0.001);the positive rates of HBsAg and HBeAg in neonatal umbilical cord blood were elevated along with the increase of maternal HBV-DNA copy (Hc= 13.50,66.70;P < 0.001).The positive rate of HBV-DNA in pregnant women with HBeAg-positive group was 100%,far more than 19.59% in HBeAg-negative group (P <0.001).Con-clusion Both maternal positive HBeAg and HBV-DNA are risk factors for neonatal intrauterine HBV infection.Prenatal HBeAg screening is predominant,especially in some hospitals without real-time quantitative assay.An effective measure to reduce intrauterine HBV infection is to be pregnant when HBV DNA and HBeAg are turned into negative after HBV inter-vention and treatment for women in reproductive age.%目的：通过对 HBsAg 阳性孕产妇及其新生儿的 HBV 检测结果分析，探讨 HBV 宫内感染的高危因素及其预防措施。方法从陕西省人民医院产前检查中筛选254例 HBsAg 阳性孕产妇及其新生儿作为研究对象，检测两者 HBV 标志物，并同时用荧光定量 PCR 检测孕产妇血清 HBV-DNA。结果254例 HBsAg 阳性孕产妇，其新生儿脐血 HBsAg 和HBeAg 阳性率分别为5.12％和13.78％；HBeAg 阳性组孕产妇的新生儿脐血 HBV 感染阳性率53.33％，远高于 HBeAg阴性组的3.61％，差异有统计学意义（P ＜0.001）；新生儿脐血 HBsAg 和 HBeAg 阳性率随孕产妇 HBV-DNA 含量的增加而升高，差异有统计学意义（K-W 秩和检验，P ＜0.001）；HBeAg 阳性孕产妇的 HBV-DNA 检测阳性率100.00％，远高于HBeAg 阴性孕产妇的阳 性 率19.59％，差异有统计学意义（Fisher 确切概率法，P ＜0.001）。结论孕产妇 HBeAg 和HBV-DNA 阳性是新生儿 HBV 宫内感染的高危因素；对于没有实时定量检测条件的基层医院和妇幼保健院，HBeAg 筛查就尤为重要；对育龄妇女孕前进行 HBV 的干预和治疗，使 HBV-DNA 和 HBeAg 转阴后妊娠，是降低 HBV 宫内感染的有力措施。
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