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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Gaps in hospital policies and practices to prevent perinatal transmission of hepatitis B virus.
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Gaps in hospital policies and practices to prevent perinatal transmission of hepatitis B virus.

机译：医院在预防围产期传播乙型肝炎病毒的政策和实践中存在差距。

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OBJECTIVE: The objective of this study was to examine hospital policies and practices to prevent perinatal transmission of hepatitis B virus (HBV) in the United States and to and identify gaps. METHODS: In March 2006, a nationally representative sample of 242 delivery hospitals in the 50 states, District of Columbia, and Puerto Rico (with at least 100 annual births) were surveyed about hospital perinatal hepatitis B prevention policies and asked to review paired maternal-infant medical records for 25 consecutive live births. Main outcome measures were hospital policies related to the prevention of perinatal transmission of hepatitis B and the proportion of infants who received recommended care. RESULTS: A total of 190 of 242 hospitals responded to the survey and completed medical record reviews for 4762 mothers and 4786 infants. The proportion of hospitals that reported each of the 6 policies examined ranged from 63.0% to 80.6%. Among infants who were born to the 18 hepatitis B surface antigen (HBsAg)-positive women with documented prenatal test results, 62.1% received both hepatitis B vaccine and hepatitis B immunoglobulin within 12 hours, but 13.7% were unvaccinated and 19.7% did not receive hepatitis B immunoglobulin before hospital discharge. Among infants who were born to the 320 women with unknown HBsAg status, only 52.4% were vaccinated within 12 hours of birth and 20.1% were unvaccinated before discharge. Among infants who were born to HBsAg-negative mothers, 69.1% received the hepatitis B vaccine before hospital discharge. The strongest predictor of vaccine administration was having a written hospital policy for newborn hepatitis B vaccination. CONCLUSIONS: These findings indicate that significant gaps persist in hospital policies and practices to prevent perinatal HBV transmission in the United States. Efforts to avoid medical errors through appropriate implementation and monitoring of hospital practices are needed to eliminate perinatal HBV transmission.
机译：目的：本研究的目的是检查医院的政策和措施，以防止在美国围产期传播乙型肝炎病毒（HBV），并找出差距。方法：2006年3月，对全国代表性的样本进行了调查，调查了50个州，哥伦比亚特区和波多黎各（每年至少出生100例）的242家分娩医院的围产期乙肝预防政策，并要求他们回顾配对的产妇-连续25次活产的婴儿医疗记录。主要结局指标是与预防围产期乙型肝炎传播有关的医院政策以及接受推荐护理的婴儿比例。结果：242家医院中共有190家对此调查作出了回应，并完成了4762名母亲和4786名婴儿的病历审查。报告检查的六项政策中的每一项的医院比例在63.0％至80.6％之间。在有记录的产前检查结果的18名乙型肝炎表面抗原（HBsAg）阳性妇女出生的婴儿中，有62.1％的人在12小时内同时接种了乙肝疫苗和乙型肝炎免疫球蛋白，但未接种疫苗的占13.7％，未接种疫苗的占19.7％出院前应接种乙肝免疫球蛋白。在320名HBsAg状况未知的妇女中出生的婴儿中，只有52.4％在出生后12小时内接种了疫苗，而20.1％在出院前未接种。在HBsAg阴性母亲出生的婴儿中，有69.1％的人在出院前接种了乙肝疫苗。疫苗接种的最有力预测指标是制定书面的新生儿乙肝疫苗接种医院政策。结论：这些发现表明在美国，防止围产期HBV传播的医院政策和实践仍然存在巨大差距。需要通过适当的实施和医院实践的监测来避免医疗错误，以消除围产期HBV传播。

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