Breastfeeding of Newborns by Mothers Carrying Hepatitis B Virus: A Meta-analysis and Systematic Review

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Breastfeeding of Newborns by Mothers Carrying Hepatitis B Virus: A Meta-analysis

and Systematic Review

Archives of Pediatrics and Adolescent Medicine, 09/14/2011

Shi Z et al. – Breastfeeding after proper immunoprophylaxis did not contribute

to mother–to–child transmission (MTCT) transmission of hepatitis B virus (HBV).

Methods

• A database was constructed from MEDLINE, EMBASE, Cochrane Library, National

Science Digital Library, and China Biological Medicine

Database and through contact with experts in this field from January 1, 1990, to

August 31, 2010.

• All studies were peer reviewed and met the preset inclusion standards.

Results

• Ten qualified studies were included. All were clinical controlled trials,

involving 751 infants in the breastfeeding group and 873 infants in the

nonbreastfeeding group.

• As indicated by infant peripheral blood hepatitis B surface antigen or HBV DNA

positivity at age 6 to 12 months, the odds ratio of MTCT of HBV in the

breastfeeding group compared with that in the nonbreastfeeding group was 0.86

(95% confidence interval, 0.51-1.45) (from 8 clinical controlled trials, P =

..56; I2 = 0%, P = .99).

• As indicated by infant peripheral blood hepatitis B surface antibody

positivity at age 6 to 12 months, the odds ratio of development of hepatitis B

surface antibodies in the breastfeeding group compared with that in the

nonbreastfeeding group was 0.98 (95% confidence interval, 0.69-1.40) (from 8

clinical controlled trials, P = .93; I2 = 0%, P = .99).

• No adverse events or complications during breastfeeding were observed.

http://archpedi.ama-assn.org/cgi/content/short/165/9/837?rss=1

ARCHIVES OF PEDIATRIC AND ADOLESCENT MEDICINE

Vol. 165 No. 9, September 2011

ONLINE FIRST

Breastfeeding of Newborns by Mothers Carrying Hepatitis B Virus

A Meta-analysis and Systematic Review

Zhongjie Shi, MD; Yuebo Yang, MD; Hao Wang, MD; Lin Ma, MD; Ann Schreiber, BSN;

Xiaomao Li, MD; Wenjing Sun, MD; Xuan Zhao, RN; Xu Yang, MD; Liran Zhang, MD;

Wenli Lu, MD; Jin Teng, MD; Yufang An, MD

Arch Pediatr Adolesc Med. 2011;165(9):837-846.

doi:10.1001/archpediatrics.2011.72

Objective To perform a systematic review of prospective studies to confirm the

role of breastfeeding in mother-to-child transmission (MTCT) of hepatitis B

virus (HBV).

Data Sources A database was constructed from MEDLINE, EMBASE, Cochrane Library,

National Science Digital Library, and China Biological Medicine Database and

through contact with experts in this field from January 1, 1990, to August 31,

2010.

Study Selection All studies were peer reviewed and met the preset inclusion

standards.

Main Exposure Breastfeeding.

Main Outcome Measures Data regarding HBV intrauterine infection, MTCT, maternal

blood and breast milk infectiousness, infant immunoprophylaxis methods and

response, and adverse events. The Mantel-Haenszel fixed-effects model was used

for all analyses using odds ratios and 95% confidence intervals.

Results Ten qualified studies were included. All were clinical controlled

trials, involving 751 infants in the breastfeeding group and 873 infants in the

nonbreastfeeding group. As indicated by infant peripheral blood hepatitis B

surface antigen or HBV DNA positivity at age 6 to 12 months, the odds ratio of

MTCT of HBV in the breastfeeding group compared with that in the

nonbreastfeeding group was 0.86 (95% confidence interval, 0.51-1.45) (from 8

clinical controlled trials, P = .56; I2 = 0%, P = .99). As indicated by infant

peripheral blood hepatitis B surface antibody positivity at age 6 to 12 months,

the odds ratio of development of hepatitis B surface antibodies in the

breastfeeding group compared with that in the nonbreastfeeding group was 0.98

(95% confidence interval, 0.69-1.40) (from 8 clinical controlled trials, P =

..93; I2 = 0%, P = .99). No adverse events or complications during breastfeeding

were observed.

Conclusion Breastfeeding after proper immunoprophylaxis did not contribute to

MTCT transmission of HBV.

Author Affiliations: Department of Obstetrics and Gynecology, Third Affiliated

Hospital of Sun Yat-sen University, Guangzhou (Drs Shi, Y. Yang, Ma, and Li),

and Department of General Surgery, The Second Affiliated Hospital (Dr Wang) and

Laboratory of Medical Genetics (Dr Sun), Harbin Medical University, and

Heilongjiang Academy of Traditional Chinese Medicine (Ms Zhao and Drs X. Yang,

Zhang, Lu, Teng, and An), Harbin, People's Republic of China; and Department of

Chemistry (Dr Shi) and Health Science Center (Dr Ma and Ms Schreiber), Temple

University, Philadelphia, Pennsylvania.

[Guest guest]

http://www.mdlinx.com/infectious-disease/newsl-article.cfm/3743044/ZZ68065536792\

5639220014/?news_id=497 & newsdt=091411 & subspec_id=130

Breastfeeding of Newborns by Mothers Carrying Hepatitis B Virus: A Meta-analysis

and Systematic Review

Archives of Pediatrics and Adolescent Medicine, 09/14/2011

Shi Z et al. – Breastfeeding after proper immunoprophylaxis did not contribute

to mother–to–child transmission (MTCT) transmission of hepatitis B virus (HBV).

Methods

• A database was constructed from MEDLINE, EMBASE, Cochrane Library, National

Science Digital Library, and China Biological Medicine

Database and through contact with experts in this field from January 1, 1990, to

August 31, 2010.

• All studies were peer reviewed and met the preset inclusion standards.

Results

• Ten qualified studies were included. All were clinical controlled trials,

involving 751 infants in the breastfeeding group and 873 infants in the

nonbreastfeeding group.

• As indicated by infant peripheral blood hepatitis B surface antigen or HBV DNA

positivity at age 6 to 12 months, the odds ratio of MTCT of HBV in the

breastfeeding group compared with that in the nonbreastfeeding group was 0.86

(95% confidence interval, 0.51-1.45) (from 8 clinical controlled trials, P =

..56; I2 = 0%, P = .99).

• As indicated by infant peripheral blood hepatitis B surface antibody

positivity at age 6 to 12 months, the odds ratio of development of hepatitis B

surface antibodies in the breastfeeding group compared with that in the

nonbreastfeeding group was 0.98 (95% confidence interval, 0.69-1.40) (from 8

clinical controlled trials, P = .93; I2 = 0%, P = .99).

• No adverse events or complications during breastfeeding were observed.

http://archpedi.ama-assn.org/cgi/content/short/165/9/837?rss=1

ARCHIVES OF PEDIATRIC AND ADOLESCENT MEDICINE

Vol. 165 No. 9, September 2011

ONLINE FIRST

Breastfeeding of Newborns by Mothers Carrying Hepatitis B Virus

A Meta-analysis and Systematic Review

Zhongjie Shi, MD; Yuebo Yang, MD; Hao Wang, MD; Lin Ma, MD; Ann Schreiber, BSN;

Xiaomao Li, MD; Wenjing Sun, MD; Xuan Zhao, RN; Xu Yang, MD; Liran Zhang, MD;

Wenli Lu, MD; Jin Teng, MD; Yufang An, MD

Arch Pediatr Adolesc Med. 2011;165(9):837-846.

doi:10.1001/archpediatrics.2011.72

Objective To perform a systematic review of prospective studies to confirm the

role of breastfeeding in mother-to-child transmission (MTCT) of hepatitis B

virus (HBV).

Data Sources A database was constructed from MEDLINE, EMBASE, Cochrane Library,

National Science Digital Library, and China Biological Medicine Database and

through contact with experts in this field from January 1, 1990, to August 31,

2010.

Study Selection All studies were peer reviewed and met the preset inclusion

standards.

Main Exposure Breastfeeding.

Main Outcome Measures Data regarding HBV intrauterine infection, MTCT, maternal

blood and breast milk infectiousness, infant immunoprophylaxis methods and

response, and adverse events. The Mantel-Haenszel fixed-effects model was used

for all analyses using odds ratios and 95% confidence intervals.

Results Ten qualified studies were included. All were clinical controlled

trials, involving 751 infants in the breastfeeding group and 873 infants in the

nonbreastfeeding group. As indicated by infant peripheral blood hepatitis B

surface antigen or HBV DNA positivity at age 6 to 12 months, the odds ratio of

MTCT of HBV in the breastfeeding group compared with that in the

nonbreastfeeding group was 0.86 (95% confidence interval, 0.51-1.45) (from 8

clinical controlled trials, P = .56; I2 = 0%, P = .99). As indicated by infant

peripheral blood hepatitis B surface antibody positivity at age 6 to 12 months,

the odds ratio of development of hepatitis B surface antibodies in the

breastfeeding group compared with that in the nonbreastfeeding group was 0.98

(95% confidence interval, 0.69-1.40) (from 8 clinical controlled trials, P =

..93; I2 = 0%, P = .99). No adverse events or complications during breastfeeding

were observed.

Conclusion Breastfeeding after proper immunoprophylaxis did not contribute to

MTCT transmission of HBV.

Author Affiliations: Department of Obstetrics and Gynecology, Third Affiliated

Hospital of Sun Yat-sen University, Guangzhou (Drs Shi, Y. Yang, Ma, and Li),

and Department of General Surgery, The Second Affiliated Hospital (Dr Wang) and

Laboratory of Medical Genetics (Dr Sun), Harbin Medical University, and

Heilongjiang Academy of Traditional Chinese Medicine (Ms Zhao and Drs X. Yang,

Zhang, Lu, Teng, and An), Harbin, People's Republic of China; and Department of

Chemistry (Dr Shi) and Health Science Center (Dr Ma and Ms Schreiber), Temple

University, Philadelphia, Pennsylvania.