목적: 본 연구 전국의 분만을 취급하는 산부인과 병의원을 대상으로 HBV 산모로부터 출생한 신생아의 백신 투여실태를 조사하는 것이다. 연구 방법: 2001년도 연간 분만 건수 100건 이상인 병의원 848곳을 대상으로 2003년 1월 15일부터 2003년 2월 15일까지 우편을 통한 설문조사를 시행하여 HBsAg 양성 산모의 신생아에게 면역글로부린 및 간염백신의 투여와 모유수유 현황을 조사하였다. 설문을 보낸 848개의 병의원 중에서 최종 회수된 설문지는 341건으로 40.2%가 회수되었다. 결과: HBsAg 양성 임신부에게 출생한 신생아에게 출생 후 면역글로부린 및 1차 간염 백신투여 시기에 대해 분포를 조사해 적기인 ‘12시간 이내에 투여하고 있는 경우가 90% 이상’이라고 보고한 병의원이 전체의 91.9%이며 분만병의원에서 현재 사용 중인 신생아 간염백신은 0-1-6방식을 가장 많이 사용하는 것으로 나타났다. 임신부의 HBsAg/HBsAb의 결과를 모르는 경우 신생아의 면역글로부린투여는 84.4%에서 ‘검사 후 결과를 보고 결정한다’는 것으로 나타났으나 간염백신 투여는 64%가 ‘HBsAg/HBsAb의 결과와 상관없이 투여한다’로 나타났다. HBsAg양성 임신부의 경우 모유수유의 권장여부를 조사하여 보면 ‘권장한다’와 ‘HBeAg 결과를 보고 권장을 결정한다’가 24.9%와 66.3%로 보고되었다. 결론: HBsAg 양성 임신부에게 출생한 신생아에게 면역글로부린 및 1차 간염 백신투여는 91.9% 병의원에서 적기인 12시간 이내에 투여하는 것으로 나타났으나 접종방식, HBsAg /HBsAb의 결과를 모르는 경우에 대해서는 투여지침에 대한 교육이 필요하다.

Objective: For evaluation of prevention program for neonatal vertical transmission from HBsAg positive mother in Korea Methods: From January 15th to February 15th 2003, the status of neonatal vaccination, immunoglobuline injection and breast feeding of HBsAg positive mother was evaluated by using mailed questionnaire in 848 hostpitals with more than 100 deliveries in the year of 2001. 341 out of 848 (40.2%) hospitals returned questionnaires. Results: 91.9% of total hospital reported that the vaccination of hepatitis B and immunoglobulin injection was done within 12 hours after birth in more than 90% of neonate. The most commonly used vaccine type was 0-1-6 method. In case of unknown result of HBsAg/ HBsAb in mother, 84.4% of hospitals delayed immunoglobulin injection until complete report, however 63% of hospitals gave hepatitis vaccine without delay before complete result. The breast feeding of HBsAg positive mother was recommended according to the result of HBeAg in 66.3% of hospitals while 24.9% of hospitals recommend breast feeding. Conclusion: Most hospitals in Korea reported that vaccination of Hepatitis B and immunoglobulin injection was done within 12 hours after in over 90% of neonate whose mother was HBsAg Positive. But continuous education and careful monitoring are required for injection method and vaccination policy in neonates of mothers with unknown result of HBsAg/HBsAb of mother.

Objective: For evaluation of prevention program for neonatal vertical transmission from HBsAg positive mother in Korea Methods: From January 15th to February 15th 2003, the status of neonatal vaccination, immunoglobuline injection and breast feeding of HBsAg positive mother was evaluated by using mailed questionnaire in 848 hostpitals with more than 100 deliveries in the year of 2001. 341 out of 848 (40.2%) hospitals returned questionnaires. Results: 91.9% of total hospital reported that the vaccination of hepatitis B and immunoglobulin injection was done within 12 hours after birth in more than 90% of neonate. The most commonly used vaccine type was 0-1-6 method. In case of unknown result of HBsAg/ HBsAb in mother, 84.4% of hospitals delayed immunoglobulin injection until complete report, however 63% of hospitals gave hepatitis vaccine without delay before complete result. The breast feeding of HBsAg positive mother was recommended according to the result of HBeAg in 66.3% of hospitals while 24.9% of hospitals recommend breast feeding. Conclusion: Most hospitals in Korea reported that vaccination of Hepatitis B and immunoglobulin injection was done within 12 hours after in over 90% of neonate whose mother was HBsAg Positive. But continuous education and careful monitoring are required for injection method and vaccination policy in neonates of mothers with unknown result of HBsAg/HBsAb of mother.

Vertical transmission, HBsAg positive mother, Neonatal immunization, Breast feeding