Table 1 General characteristic and quality score of the 32 studies included in this meta analysis

1.

De Martino[11]

1985

3

NA

Italy

85 cases

12 months

Prospective

APCW, S+ and C+; a normal pregnancy; informed consent.

2.3(E)

Normal ALT and birth weight.

0.5 ml/kg HBIG/8 h + 1 ml(P)/2-4-11 m

Sex ratio of 1.2, no medication except a multivitamin mixture, vaccination against polio, tetanus and diphtheria; monthly visit, no dropout; no vaccine-related serious side effect and no abnormal ALT was observed at the end of follow up.

Mothers' E+% and newborns' gender were similar between BF and FF.

2.

Tseng [12]

1988

3

NA

Hongkong, China

170 cases

12 months

Retrospective

PCW, S+.

64(E) among BF

0.5 ml HBIG/24 h + 5 μg (P)/0-1-6 m

3.

Huang [22]

1993

3

Aug. 1989-Sept. 1990

Guangdong, China

112 cases

12 months

Retrospective

PCW, S+.

44.8(E)

S+% = 6.4 and E+% = 25.6 (U) at birth.

30 μg(P)/0-1-6 m

9-12

Average age of the mothers was 26.97 ± 2.83 years old.

4.

Wu [23]

1996

3

1992-1993

Nanjing, China

80 cases

6 months

Retrospective

PCW, S+.

55.6(E) among BF

Full-term normal delivery.

200IU HBIG/4 h,1 m +30 μg(P)/1-3-6 m.

12

Mothers' age were similar between BF and FF.

5.

Zeng [24]

2001

4

Jan. 1996-Jun. 1999

Guangdong, China

190 cases

9 months

Retrospective

PCW, S+; normal ALT.

29.5(E)

S+% = 14.9(U, 134cases) at birth.

10 μg (R)/0-1-6 m

Mothers' E+% was higher in FF than BF.

6.

Wu [25]

2002

3

Jan. 1995-Dec. 2000

Nanjing, China

300 cases

12 months

Retrospective

PCW, S+; normal hepatic function; no nipple crack; 200IU-HBIG treatment.

100 (E)

Complete gestation birth; no oral ulcer.

200IU HBIG/4 h,1 m+10 μg (R)/1-3-6 m with booster.

11

Mothers' age range was 25-31 years.

7.

Hill [10]

2002

6

Jan. 1992-Sept. 1998

Texas, The United States

369 cases

9-15 months

Prospective

PCW, S+, CG+ and CM-

24.5(E, 179 cases)

0.5 ml HBIG+ 0-1-6 mwith booster.

4.9

Complete follow-up and vaccination; mothers' nulliparous% (all cases), AST/ALT level, anti-HCV+%, HIV-1+%, E+%, CG+% and CM+% based on available cases, and newborns' gender were similar between BF and FF.

Mothers were younger and with more blacks in FF than BF.

8.

Wang [13]

2003

5

1994-1999

Shanghai, China

230 cases

12 months

Retrospective

APCW, S+; normal ALT.

34(E)

37-42 gestation weeks; S+% = 10.9 at birth.

30 μg(P, before 1997) or 5 μg(R, after 1997)/0-1-6 m or/24 h+1-2-7 m

≥ 2

Those infants were excluded with an obvious abnormality, birth weight < 2500 g, or an apgar score of < 8 at 1 or 5 minutes.

Mothers' E+%, newborns' gender, birth weight and S+% at birth were similar between BF and FF.

BF group received more active immunization than FF.

9.

Zeng [26]

2003

2

May 1995-Sept. 1997

Sichuang, China

53 cases

12 months

Retrospective

PCW, S+.

100(E or DNA)

S-at birth.

200IU HBIG/24 h+30 μg(P)/2 w,10 μg/1.5 m, 10 μg/6.5 m

≥ 4

Duration of breastfeeding < 4 months was excluded.

10.

Gu [27]

2003

3

1998-1999

Nanjing, China

152 cases

12 months

Prospective

PCW, S+ and c+; 200~400IU-HBIG treatment

0(E)

Healthy; complete gestation weeks; birth weight > 3000 g; S+% = 7.6 at birth.

10 μg(R, 80 cases) or 30 μg (P, 72 cases)/24 h-1-6 m

Proportion of types of vaccines was similar between BF and FF.

11.

He [28]

2004

3

Dec. 1997-Dec. 1999

Inner Mongolia, China

38 cases

12 months

Retrospective

PCW, S+.

100(DNA)

DNA+% = 56(U)

100-200IU HBIG/6 h, 2 w+ 0-1-6 m

12.

Liu [29]

2004

3

Feb. 1998-Feb. 2001

Henan, China

436 cases

12 months

Retrospective

APCW, S+; 200IU-HBIG treatment.

S+% = 8.7 and E+% = 0.9 at birth

200IU HBIG/24 h, 2 w+5 μg(R)/0-1-6 m

Newborns' S+% and E+% at birth were similar between BF and FF.

13.

Yao [30]

2004

4

Dec. 2000-Jun. 2002

Zhejiang, China

190 cases

12 months

Retrospective

PCW, S+; 200IU-HBIG treatment.

72.9(E)

Healthy; complete gestation weeks; DNA+% = 5.0 and S+% = 6.3 at birth.

200IU HBIG/6-12 h,2 w+5 μg(R)/0-1-6 m

Mothers' age, uterine contraction+%, duration of uterine contraction, E+% and HBV+%, and newborns' gestation weeks and birth weight were similar between BF and FF.

14.

Meng [31]

2004

4

Mar. 2001-Mar. 2003

Guangdong, China

134 cases

6 months

Prospective

PCW, S+; normal ALT; 200IU-HBIG treatment (66 cases).

S+% = 16.4, E+% = 6.7 and DNA+% = 2.2 at birth.

0-1-6 m

No foetus abnormality, no history of treatment of anti-virus drugs during pregnancy, TORCH syndrome and other diseases.

15.

Mou [32]

2005

5

Sept. 2001-Oct. 2003

Shandong, China

91 cases

12 months

Prospective

PCW, S+; normal hepatic function; informed consent.

33.0(E)

37.4(DNA)

DNA+% = 13.2 (U) at birth.

200IU HBIG/12 h,2 w+0-1-6 m with booster.

≥ 1

Exclusion for those with premature birth, low birth weight, asphyxia and history of bleeding during pregnancy, breastfeed < 1 month.

Mothers' E+% and DNA+%, newborns' gestation weeks, birth weight and DNA+% (U) were similar between BF and FF.

16.

Zhang [33]

2005

4

2000-2004

Ningxia, China

104 cases

12 months

Prospective

PCW, S+; 200IU-HBIG treatment.

100(E)

200IU HBIG/24 h, 1 m+10 μg(R)/2-3-6 m

Natural delivery% = 50.0

17.

Zhang [34]

2005

3

Jan. 2001-Feb. 2002

Chongqing, China

67 cases

12-18 months

Retrospective

PCW, S+; 100IU-HBIG treatment.

28.4(E)

200IU HBIG/24 h+100IU HBIG/15d+10 μg(R)/2-3-6 m

Mothers' E+% was higher in FF than BF.

18.

Qiu [35]

2005

3

Dec. 2002-Mar. 2004

Zhejiang, China

90 cases

6 months

Retrospective

PCW, S+; normal hepatic function; no nipple crack; 200IU-HBIG treatment.

100(E)

Healthy; complete gestation weeks.

200IU HBIG/6 h+5 μg (R)/12 h-1-6 m

> 6

Mothers' age and DNA+%, newborns' gestation weeks were similar between BF and FF.

19.

Zeng [36]

2006

4

Jun. 2001-Dec. 2003

Guangxi, China

115 cases

7 months

Prospective

PCW, S+; normal ALT; 200IU-HBIG treatment.

31.3(E)

Apgar > 7; birth weight > 2500 g; S+% = 12.2 at birth.

200IU HBIG/24 h, 1 m+ 5 μg (R)/72 h-1-6 m

> 0.5

Mothers' E+%, newborns' gender, birth weight and HBV+% at birth were similar between BF and FF.

20.

Ma [7]

2006

4

1993-1999

Liaoning, China

167 cases

9 months

Retrospective

PCW, S+.

54(E)

Birth temperature < 37°C; birth weight > 2500 g; apgar > 8.

(R)/0-1-6 m

Mothers' E+% was similar between BF and FF.

21.

Chen [37]

2006

4

Mar. 2002-May. 2005

Zhejiang, China

170 cases

12 months

Retrospective

APCW, S+; normal hepatic function; informed consent.

41.2(E)

DNA+% = 9.4(U).

200IU HBIG/12 h,14 d+5 μg(R)/0-1 -6 m with booster

≥ 1

Exclusion for those with premature birth, low birth weight, asphyxia and history of bleeding during pregnancy, breastfeeding below one month.

Mothers' E+% and DNA+%, newborns' birth weight, gestation weeks and DNA+% were similar between BF and FF.

22.

Zuo [38]

2007

4

May 2004-May 2005

Hebei, China

180 cases

12 months

prospective

PCW, S+; 200IU-HBIG treatment.

49.4(E)

S+% = 6.7 and DNA+% = 4.2 at birth.

200IU HBIG/48 h,1 m,3 m+5 μg(R)/24 h-1 -6 m

10

The infants were randomized into two groups.

Mothers' age, E+% and DNA+%, newborns' birth weight, method of delivery, S+% and DNA+% were similar between BF and FF.

23.

Wang [39]

2007

3

Oct. 2003-Jan. 2006

Ningxia, China

165 cases

10-12 months

Retrospective

APCW, S+.

0(E)

S+% = 11.5 and E+% = 2.4.

200IU HBIG/6 h+5 μg(R)/2 d-1-6 m

Mothers' age and DNA level, newborns' sex ratio, birth weight and method of delivery were similar between BF and FF.

24.

Qin [40]

2007

3

Jan. 2001-Jan. 2005

Henan, China

74 cases

12 months

Retrospective

PCW, DNA+; 200IU-HBIG treatment.

100(DNA)

DNA+% = 4.5 at birth

200IU HBIG/16 h+10 μg(R)/1-2-7 m or 10 μg(R)/0-1-6 m

25.

Chen [41]

2008

4

Oct. 2002-Aug. 2007

Beijing, China

345 cases

12 months

Retrospective

PCW, S+.

0(E and DNA)

10 μg(R)/0-1-6 m+ 100-200IU HBIG/24 h, 15-30d(241 cases).

Proportion of infants who received HBIG was higher in FF than BF.

26.

Hou [42]

2009

4

Jan. 2002-NA

Shenzhen, China

369 cases

9-15 months

Retrospective

PCW, S+; abnormal ALT/AST% = 2.2.

13.6(E)

100IU HBIG/1 d+5 μg(R)/0-1-6 m with booster.

4.9

Mothers' age, abnormal ALT/AST%, E+%, CM+% and CG+%, newborns' sex ratio were similar between BF and FF.

27.

Li [43]

2009

2

2004-2007

Shandong, China

45 cases

12 months

Retrospective

APCW, S+; normal hepatic function; 200IU-HBIG treatment.

33.3(E)

DNA+% = 10.0 at birth.

200 IU HBIG/12 h, 2 w+ 0-1-6 m with booster.

Mothers' E+% and DNA+%, newborns' gestation weeks, birth weight and DNA+% were similar between BF and FF.

28.

Luo [44]

2010

4

2007-2009

Fujian, China

436 cases

6 months

retrospective

PCW, S+; normal hepatic function; 200IU-HBIG treatment.

44.0(E)

200 IU HBIG/12 h, 2 w+5 μg(R)/0-1-6 m

> 6

Mothers' E+% and DNA+% were higher in FF than BF.

29.

Chen [45]

2010

3

2001-2009

Shandong, China

278 cases

8-12 months

Retrospective

PCW, S+; 200IU-HBIG voluntary treatment.

200IU HBIG/24 h,2 w or 200IU HBIG/24 h +0-1-6 m or 0-1-2-7 m

Mothers' age range was 21-40 years old.

30.

Sun [46]

2010

2

Nov. 2007-Jul. 2008

Shandong, China

69 cases

12 months

retrospective

PCW, S+.

DNA-at birth

HBIG+(R)/0-1-6 m

31.

Liu [47]

2010

4

Jan. 2009-Mar. 2010

Guangdong, China

145 cases

12 months

retrospective

PCW, S+; 200IU-HBIG treatment.

58.1(DNA)

200IU HBIG+5 μg (R)/0-1-6 m

> 6

Mothers' DNA+%, age, time of pregnancy and delivery, methods of delivery, newborns' birth weight, S+% and DNA+% at birth were similar between BF and FF.

32.

Wu [48]

2010

3

Sept. 2007-May. 2009

Guangdong, China

46 cases

12 months

Retrospective

PCW, S+.

100 (both E and DNA)

200IU HBIG/6 h+5 μg(R)/0-1-6 m

Mothers' age, newborns' sex ratio, birth weight and methods of delivery were similar between BF and FF.