شیوع و عوامل خطر عفونت هپاتیت B در زنان باردار ایران: یک مطالعه مرور سیستماتیک و متاآنالیز

نوع مقاله : مروری

نویسندگان

1 دانشجوی پزشکی، کمیته تحقیقات دانشجویی، دانشکده پزشکی، دانشگاه علوم پزشکی ایلام، ایلام، ایران.

2 کارشناس ارشد پرستاری داخلی جراحی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی دزفول، دزفول، ایران.

3 دانشیار گروه زنان و مامایی، مرکز تحقیقات سلامت باروری زنان، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

4 دانشجوی کارشناسی ارشد اپیدمیولوژی، کمیته تحقیقات دانشجویی، دانشکده بهداشت، دانشگاه علوم پزشکی ایلام، ایلام، ایران

5 دانشجوی دکترای پژوهشی، مرکز تحقیقات پیشگیری از آسیب های روانی- اجتماعی، دانشکده بهداشت، دانشگاه علوم پزشکی ایلام، ایلام، ایران.

6 استاد گروه اپیدمیولوژی بالینی، دانشکده بهداشت، دانشگاه علوم پزشکی ایلام، ایلام، ایران.

7 دانشجوی کارشناسی پرستاری، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی دزفول، دزفول، ایران.

چکیده

مقدمه: انتقال پری‌ناتال یکی از رایج‌ترین مسیرهای انتقال هپاتیت  B(HBV ) در سراسر جهان است. در ایران بیش از 50% حاملین HBV، عفونت را از این طریق دریافت کرده‌اند. لذا این مطالعه مروری با هدف بررسی شیوع و عوامل خطر HBV در زنان باردار ایران انجام شد.
روش‌کار: مطالعه حاضر بر اساس چک لیست PRISMA برای مطالعات مرور سیستماتیک و متاآنالیز انجام شد. جهت دستیابی به مستندات فارسی و انگلیسی مرتبط، پایگاه‌های الکترونیکی Scopus، PubMed، Science-Direct، Cochrane، Web of Science (ISI)، Springer، Online Library Wiley،Magiran ، Iranmedex، SID، Medlib، IranDoc و موتور جستجوی Google Scholar با استفاده از کلیدواژه‌های استاندارد شامل: شیوع، هپاتیت B، زنان باردار، بارداری، عوامل خطر، HBsAg و ایران بدون محدودیت زمانی تا بهمن ماه 1394 توسط دو پژوهشگر جستجو شدند. داده‌های شیوع HBV با استفاده از مدل اثرات تصادفی و عوامل خطر HBV براساس مدل اثرات ثابت توسط نرم افزار STATA (نسخه 2/11) مورد تجزیه و تحلیل آماری قرار گرفتند.
یافته‌ها: در بررسی 36 مطالعه واجد شرایط با حجم نمونه 64195 زن باردار در ایران،شیوع HBV 5/0%(CI 95%: 6/0-5/0) محاسبه شد. کمترین و بیشترین شیوع HBV مرتبط با شمال (4/0%) و شرق ایران (6/1%) بود. شیوع HBV در زنان باردار شهری و روستایی به ترتیب 1/1 و 2/1% برآورد شد. شیوع HBV در زنان باردار خانه‌دار 7/1% و در زنان باردار شاغل 1/0% بدست آمد. فراوانی HBsAb(AntiHBS>10 mIU/ml) در زنان باردار ایرانی 40% محاسبه شد. از میان عوامل خطر، بی‌سوادی، شغل، سقط جنین، سابقه تزریق خون و اعتیاد همسر با ابتلاء به HBV از نظر آماری معنی‌دار بود (05/0>p)، اما این ارتباط با شهرنشینی، سابقه جراحی و خالکوبی معنی‌دار نبود (05/0<p).
نتیجه‌گیری: کمترین شیوع هپاتیت B در ایران، در گروه زنان باردار می‌باشد و کمتر از جمعیت عمومی ایران است. تزریق خون، شغل، اعتیاد همسر، بی‌سوادی و سقط جنین با ابتلاء به HBV در زنان باردار ایران در ارتباط است.

کلیدواژه‌ها

عنوان مقاله [English]

Prevalence and Risk Factors of Hepatitis B Infection in Pregnant Women of Iran: A Systematic Review and Meta-Analysis

نویسندگان [English]

  • Milad Azami 1
  • Marzieh Khataee 1
  • Marzieh Beigom Bigdeli Shamloo 2
  • Fatemeh Abbasalizadeh 3
  • Shoboo Rahmati 4
  • Shamsi Abbasalizadeh 3
  • Yousef Veisani 5
  • Ali Delpisheh 6
  • Yaeghoob Madmoli 7
1 Medical Student, Student Research Committee, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
2 M.Sc. student of Surgery Internal Nursing, School of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran.
3 Associate professor, Department of Obstetrics & Gynecology, Women’s Reproductive Health Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
4 M.Sc. student of Epidemiology, Student Research Committee, School of Health, Ilam University of Medical Sciences, Ilam, Iran.
5 PhD student of Research, Psychosocial Injuries Prevention Research Center, Ilam University of Medical Sciences, Ilam, Iran.
6 Professor, Department of Clinical Epidemiology, School of Health, Ilam University of Medical Sciences, Ilam-Iran.
7 Nursing student, Student Research Committee, School of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran.
چکیده [English]

Introduction: Perinatal transmission is one of the most common routes of hepatitis B virus (HBV) transmission in the worldwide. In Iran, more than 50% of HBV carriers have received the infection in this route. Therefore, this review study was performed with aim to determine the prevalence and risk factors of HBV infection in pregnant women of Iran.
Methods: Current study was conducted based on PRISMA checklist for systematic review and meta-analysis studies. To access to the English and Persian documents, two independent authors searched Scopus, PubMed, ScienceDirect, Cochrane, Web of Science (ISI), Springer, Online Library Wiley, Magiran, Iranmedex, SID, Medlib, IranDoc and Google Scholar search engine up to January 2016 by using Mesh keywords including: Prevalence, Hepatitis B, Pregnant women, Pregnancy, Risk Factors, HBsAg and Iran. Data was analyzed using the random-effects model for HBV prevalence and fixed-effects model for risk factors of HBV via Stata software (Version 11.2).
Results: A total of 36 eligible studies with sample size of 64,195 pregnant women in Iran, HBV prevalence was estimated 0.5%. Minimum and maximum of this range were related to the North (0.4%) and East (1.6%) of the Iran. HBV prevalence in urban and rural pregnant women was estimated 1.1 and 1.2%, respectively. HBV prevalence among housewife pregnant women was 1.7% and employee pregnant women was 0.1%. The frequency of HBsAb>10 mIU/ml in Iranian pregnant women were calculated 40%. Among the risk factors, illiteracy, occupation, blood transfusion, abortion and husband addiction were significant related with prevalence of HBV (P<0.05), but this relationship was not statistically significant with urbanization, history of surgery and tattooing (P>0.05).
Conclusion: The lowest prevalence of HBV in Iran was related to pregnant women and less than the general population. History of blood transfusions, husband addiction, illiteracy, occupation and abortion are associated with HBV in Iranian pregnant women.

کلیدواژه‌ها [English]

  • Hepatitis B
  • Meta-analysis
  • Pregnant Women
  • Prevalence
  • Risk factors

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مجله زنان، مامایی و نازایی ایران
دوره 19، شماره 18
هفته دوم مرداد ماه 1395
مرداد 1395
صفحه 17-30

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