China ; epidemiology ; Female ; Hepatitis B ; prevention & control ; transmission ; Humans ; Infectious Disease Transmission, Vertical ; prevention & control ; Pregnancy ; Pregnancy Complications, Infectious

OBJECTIVETo explore the efficacy of prevention programs and relevant factors targeting mother-to-infant transmission of HBV in Yunnan province.

METHODSIn Yunnan province, we selected HBsAg positive pregnant women that delivered in hospital from January 1st through June 30th, 2011. Newborns of these pregnant women were under PMTCT (prevention of mother to child treatment) program and followed. Every infant was drawn 2 ml venous blood and questionnaire survey was carried out when the baby was 7-12 month-old and completed the vaccination processes. Serum samples of them were then collected and detected on the 5 serological indicators of HBV.

RESULTSwere analyzed statistically.

RESULTSThere were 2 765 infants in the study program. The success rate of PMTCT was 95.88% . Rates of coverage on both timely-birth dose and 3 doses of HepB were 97.03% and 92.30% respectively. The overall vaccinated rate and timely-birth vaccinated rate on hepatitis B immunoglobulin (HBIG) were 68.97% and 94.49% respectively. The success rate of PMTCT was 97.16% after administration of passive-active immune-prophylaxis (HepB and HBIG), compared to the rate as 93.01% when vaccinated with HepB only. Significant differences were seen in the successful rates of PMTCT between combined and non-combined immunization. Either the combined or non-combined immunization, there were significant differences seen in the success rates of PMTCT regardless the positivity status of HBsAg or HBeAg, among the infected mothers.

CONCLUSIONThe efficacy of passive-active immune-prophylaxis program seemed to be better than the one without combined immunization. It was vitally important for the infants whose mothers' HBsAg and HBeAg status were positive, to receive regular and timely combined immunization. In order to promote the PMTCT in Yunnan province, vaccinated rate on HBIG should be further improved.

China ; epidemiology ; Female ; Hepatitis B ; epidemiology ; prevention & control ; Hepatitis B virus ; Humans ; Immunization ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; prevention & control ; Mothers ; Pregnancy ; Pregnancy Complications, Infectious ; prevention & control

OBJECTIVETo evaluate the cost-effectiveness and economic efficiency of integrated prevention of mother-to-child transmission (PMTCT) of HIV in four high-incidence counties.

METHODSData of local resource investment and total cost for PMTCT in 4 counties in China from 2003 to 2006 were collected. Cost analysis and cost-effectiveness analysis were conducted. Average costs of a confirmed HIV case, a prevented case and a disability-adjusted life-year (DALY) saving were calculated.

RESULTSAverage cost of identifying one HIV-infected mother was yen5512. Costs of a pediatric HIV case prevention and per DALY saving were yen46 747 and yen1870 ($231), respectively, based on the total cost perspective.

CONCLUSIONThe cost of integrated prevention of mother-to-child transmission of HIV was low. The PMTCT program was economical efficiency.

Acquired Immunodeficiency Syndrome ; prevention & control ; transmission ; Cost-Benefit Analysis ; Female ; Humans ; Infectious Disease Transmission, Vertical ; prevention & control ; Pregnancy ; Pregnancy Complications, Infectious ; prevention & control ; Universal Precautions ; economics

In this paper, we provide guidance to clinicians who care for infants born to mothers with suspected/confirmed COVID-19 during this current pandemic. We reviewed available literature and international guidelines based on the following themes: delivery room management; infection control and prevention strategies; neonatal severe acute respiratory syndrome coronavirus 2 testing; breastfeeding and breastmilk feeding; rooming-in of mother-infant; respiratory support precautions; visiting procedures; de-isolation and discharge of infant; outpatient clinic attendance; transport of infant; and training of healthcare staff. This guidance for clinical care was proposed and contextualised for the local setting via consensus by members of this workgroup and was based on evidence available as of 31 July 2020, and may change as new evidence emerges.
Infant, Newborn ; Pregnancy ; Female ; Humans ; Mothers ; COVID-19/epidemiology* ; Singapore/epidemiology* ; COVID-19 Testing ; Pandemics/prevention & control* ; Infectious Disease Transmission, Vertical/prevention & control* ; Pregnancy Complications, Infectious/prevention & control*

China ; Female ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans ; Infectious Disease Transmission, Vertical/prevention & control* ; Pregnancy ; Pregnancy Complications, Infectious/prevention & control* ; Pregnant Women

Objective: To summarize the management and short-term outcomes of neonates delivered by mothers infected with SARS-CoV-2 Omicron variant. Methods: A retrospective study was performed on 158 neonates born to mothers infected with SARS-CoV-2 Omicron variant admitted to the isolation ward of Children's Hospital of Fudan University from March 15^th, 2022 to May 30^th, 2022. The postnatal infection control measures for these neonates, and their clinical characteristics and short-term outcomes were analyzed. They were divided into maternal symptomatic group and maternal asymptomatic group according to whether their mothers had SARS-CoV-2 symptoms. The clinical outcomes were compared between the 2 groups using Rank sum test and Chi-square test. Results: All neonates were under strict infection control measures at birth and after birth. Of the 158 neonates, 75 (47.5%) were male. The gestational age was (38⁺³±1⁺³) weeks and the birth weight was (3 201±463)g. Of the neonates included, ten were preterm (6.3%) and the minimum gestational age was 30⁺¹ weeks. Six neonates (3.8%) had respiratory difficulty and 4 of them were premature and required mechanical ventilation. All 158 neonates were tested negative for SARS-COV-2 nucleic acid by daily nasal swabs for the first 7 days. A total of 156 mothers (2 cases of twin pregnancy) infected with SARS-CoV-2 Omicron variant, the time from confirmed SARS-CoV-2 infection to delivery was 7 (3, 12) days. Among them, 88 cases (56.4%) showed clinical symptoms, but none needed intensive care treatment. The peripheral white blood cell count of the neonates in maternal symptomatic group was significantly higher than that in maternal symptomatic group (23.0 (18.7, 28.0) × 10⁹ vs. 19.6 (15.4, 36.6) × 10⁹/L, Z=2.44, P<0.05). Conclusions: Neonates of mothers infected with SARS-CoV-2 Omicron variant during third trimester have benign short-term outcomes, without intrauterine infection through vertical transmission. Strict infection control measures at birth and after birth can effectively protect these neonates from SARS-CoV-2 infection.
Female ; Humans ; Infant ; Infant, Newborn ; Male ; Pregnancy ; COVID-19 ; Mothers ; Pregnancy Complications, Infectious/prevention & control* ; Retrospective Studies ; SARS-CoV-2

OBJECTIVETo demonstrate the effectiveness of prevention of mother-to-child HIV, syphilis, and hepatitis B transmission among pregnant women in Dehong prefecture, Yunnan province, China from 2011 to 2013.

METHODSData were collected mainly from the continuous HIV surveillance system and prevention of mother-to-child transmission (PMTCT) reporting system of Dehong prefecture, and supplemented by annual reported data on HIV, syphilis, and hepatitis B PMTCT to know the general demographic characteristics, HIV testing and counseling service, PMTCT service, and other medical services. Data were presented as absolute numbers and proportions.

RESULTSFrom 2011 to 2013, the number of pregnant women participating in HIV, syphilis, and hepatitis B testing in Dehong prefecture increased and the HIV testing rates were 99.2% (18 694/18 854), 99.9% (22 047/22 060) and 99.9% (21 751/21 756), the syphilis testing rates were 56.0% (10 550/18 854), 99.6% (21 980/22 060) and 99.9% (21 751/21 756), and the hepatitis B testing rates were 60.2% (11 358/18 854), 99.6% (21 974/22 060) and 99.9% (21 751/21 756). From 2011 to 2013, the HIV positive rates were 0.87% (327/37 787),0.82% (319/38 817) and 0.85% (315/37 261), the syphilis positive rates were 0.05% (10/18 520),0.12% (43/36 817) and 0.11% (40/35 888), the hepatitis B positive rates were 2.46% (456/18 520), 2.23% (794/35 547) and 2.14% (739/34 468), respectively. The rates of HIV-positive pregnant women giving birth in hospitals were 99.2% (128/129), 100.0% (141/141) and 100.0% (141/141). From 2011 to 2013, the proportions of HIV-positive pregnant women receiving antiretroviral therapy were 99.2% (128/129), 99.3% (140/141) and 99.3% (140/141), respectively. And the treatment rate of syphilis-positive pregnant women were 71% (5/7), 89% (16/18) and 97% (32/33). The rates of hepatitis B immunoglobulin injection among new-borns of hepatitis B-positive pregnant women were 92.9% (263/283), 99.7% (612/614) and 99.4% (629/633). The estimated rates of mother-to-child transmission of HIV were 2.28%, 2.30% and 3.00%, respectively.

CONCLUSIONThere was an increasing trend of HIV, syphilis, and hepatitis B testing rate and the positive rate kept at a low level. The proportions of HIV-positive pregnant women receiving HIV, syphilis, and hepatitis B PMTCT services increased annually, while the proportion of HIV MTCT kept at an overall low level from 2011 to 2013, which indicated its effectiveness of HIV PMTCT work during recent years in Dehong prefecture,Yunnan province, China.

Child ; China ; Female ; HIV Infections ; Hepatitis B ; Humans ; Immunoglobulins ; Infectious Disease Transmission, Vertical ; prevention & control ; Mass Screening ; Mothers ; Pregnancy ; Pregnancy Complications, Infectious ; Syphilis

Group B Streptococcus (GBS) is responsible for two distinct clinical syndromes in the newborn period categorised as either early- or late-onset GBS disease. Maternal GBS colonization of gastrointestinal tract or vaginal is the major risk factor for GBS diseases. There are two main strategies for identifying women at risk of giving birth to a GBS-infected infant: universal screening strategy and risk-based assessment. In the United States and other countries, the implementation of maternal intrapartum antibiotic prophylaxis policies has significantly reduced the incidence of early-onset neonatal GBS disease, but has little effect on the incidence of late-onset GBS disease. Penicillin is the first choice for antibiotic prophylaxis treatment. GBS strains which are isolated from pregnant women who are allergic to penicillin should undergo antibiotic susceptibility testing. Antibiotic prophylaxis measures have some disadvantages, so researchers should actively develop other precautions to prevent GBS infection.
Antibiotic Prophylaxis ; Female ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Pregnancy ; Pregnancy Complications, Infectious ; Streptococcal Infections ; etiology ; prevention & control ; Streptococcus agalactiae

Currently, the main strategy for preventing neonatal group B Streptococcus (GBS) infection is prenatal screening combined with intrapartum antibiotic prophylaxis, which has effectively reduced the incidence of neonatal GBS early-onset disease. However, the burden of GBS infection is still significant. The intrapartum antibiotic prophylaxis strategy has limitations such as inducing antibiotic resistance and inability to effectively prevent GBS late-onset disease. It is crucial to develop and evaluate other prevention strategies, while paying close attention to assessing penicillin allergy in pregnant women and how to prevent GBS infection in neonates with negative maternal GBS screening. In recent years, there has been some progress in GBS vaccines and related immunological research, and the use of specific vaccines is expected to significantly reduce GBS infection in neonates.
Female ; Humans ; Infant, Newborn ; Pregnancy ; Anti-Bacterial Agents/therapeutic use* ; Antibiotic Prophylaxis ; Infectious Disease Transmission, Vertical/prevention & control* ; Pregnancy Complications, Infectious/epidemiology* ; Streptococcal Infections/drug therapy* ; Streptococcus agalactiae

Objective: To analyze the association between different treatment timings and adverse neonatal outcomes (premature birth, death, congenital syphilis) in syphilis-infected pregnant women. Methods: The National Management Information System for Prevention of HIV, Syphilis and HBV Mother-to-Child Transmission was used to collect information on the detection and treatment of syphilis-infected pregnant women and their newborns in Guangdong Province from October 2011 to December 2021. According to the gestational weeks of syphilis-infected pregnant women receiving penicillin treatment for the first time, they were divided into four groups: treatment in the first trimester, treatment in the second trimester, treatment in the third trimester, and no treatment during pregnancy. Multivariate logistic regression was used to analyze the association between different treatment timings and adverse neonatal outcomes in syphilis-infected pregnant women. Results: A total of 22 483 syphilis-infected pregnant women were included. The number of pregnant women who started treatment in the first trimester, second trimester, and third trimester and did not receive treatment during pregnancy were 4 549 (20.23%), 8 719 (38.78%), 2 235 (9.94%) and 6 980 (31.05%), respectively. Compared with pregnant women who started treatment in the first trimester, pregnant women who did not receive anti-syphilis treatment during pregnancy had increased risks of neonatal preterm birth (OR=1.42, 95%CI: 1.24-1.62), death (OR=4.27, 95%CI: 1.64-14.69) and congenital syphilis (OR=12.26, 95%CI: 6.35-27.45). At the same time, the risk of congenital syphilis in the newborns of pregnant women who started anti-syphilis treatment in the second trimester (OR=2.68, 95%CI: 1.34-6.16) and third trimester (OR=6.27, 95%CI: 2.99-14.80) also increased. Conclusion: Early initiation of anti-syphilis treatment during pregnancy in patients with syphilis can improve neonatal outcomes.
Pregnancy ; Female ; Infant, Newborn ; Humans ; Pregnant Women ; Syphilis/diagnosis* ; Pregnancy Complications, Infectious/drug therapy* ; Syphilis, Congenital/drug therapy* ; Premature Birth ; Infectious Disease Transmission, Vertical/prevention & control*