孕期乙型肝炎临床护理服务:澳大利亚维多利亚州的全人口关联研究。

IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Jennifer H MacLachlan, Nicole Romero, Nicole Allard, Stacey L Rowe, Benjamin C Cowie
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引用次数: 0

摘要

背景和目的:由于慢性乙型肝炎 (CHB) 会传染给婴儿,而且产前诊断为持续随访提供了机会,因此孕期是接受慢性乙型肝炎 (CHB) 治疗的关键时期。本研究旨在通过人群队列确定妊娠期间和妊娠后慢性乙型肝炎妇女临床护理的覆盖范围和预测因素:方法:将澳大利亚维多利亚州通报的慢性阻塞性肺病病例与住院、医疗服务和处方数据联系起来,时间跨度为 1991-2018 年。对因活产而入院的妇女进行了鉴定,并对孕期提供的服务进行了评估,包括全科医生(GP)或专科医生就诊、病毒载量和血清学检测以及抗病毒治疗。还对怀孕后两年内的病毒载量和血清学检测覆盖率进行了评估。还评估了孕期病毒载量检测的人口统计学和临床预测因素:结果:6090 名患有慢性阻塞性肺病的妇女共发生了 11 015 例分娩。在怀孕期间,大多数人都接受过全科医生咨询(91.6%);但只有 39.5% 的人接受过病毒载量检测,41.4% 的人接受过消化内科或传染病专科医生咨询。约有一半的孕妇(分别为 47.9% 和 52.2%)在怀孕后两年内进行了病毒载量检测和血清学检测,而且随着时间的推移,检测比例也在增加。海外出生者、曾生育过一次以上者和居住在墨尔本者更有可能接受病毒载量检测:尽管随着时间的推移情况有所改善,但在妊娠期间和妊娠后提供的慢性阻塞性肺病临床护理方面仍存在主要差距,这对持续传播和不良后果产生了影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hepatitis B clinical care provision in pregnancy: A whole-of-population linkage study in Victoria, Australia.

Background and aim: Pregnancy is a key setting for engagement in chronic hepatitis B (CHB) care, due to the implications for transmission to the infant and antenatal diagnosis representing an opportunity for ongoing follow-up. This study aimed to identify the coverage and predictors of clinical care for women with CHB during and after pregnancy in a population-level cohort.

Methods: Notified CHB cases in Victoria, Australia, were linked with hospitalizations, medical services, and prescribing data, covering the period 1991-2018. Women with an admission for a live birth were identified and services provided during pregnancy were assessed, including general practitioner (GP) or specialist visits, viral load and serology testing, and antiviral treatment. Viral load and serology testing coverage ware also assessed for the 2-year period following pregnancy. Demographic and clinical predictors of viral load testing during pregnancy were assessed.

Results: A total of 11 015 birth events occurred for 6090 women with CHB. During pregnancy most had a GP consultation (91.6%); however, only 39.5% had viral load testing and 41.4% had a gastroenterology or infectious diseases specialist consultation. Viral load testing and serology testing in the 2 years after pregnancy occurred in approximately half (47.9% and 52.2%, respectively) with increases over time. Viral load testing was more likely in those born overseas, those with more than one previous birth, and those living in Melbourne.

Conclusions: Despite improvements over time, key gaps were identified in the provision of CHB clinical care during and after pregnancy, with implications for ongoing transmission and adverse outcomes.

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来源期刊
CiteScore
7.90
自引率
2.40%
发文量
326
审稿时长
2.3 months
期刊介绍: Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.
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