Maternal HBsAg carriers and pregnancy outcomes: a retrospective cohort analysis of 85,190 pregnancies
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(2020) 20:724
RESEARCH ARTICLE
Open Access
Maternal HBsAg carriers and pregnancy outcomes: a retrospective cohort analysis of 85,190 pregnancies Yulong Zhang†, Jiacheng Chen†, Tingting Liao, Siwen Chen, Jianying Yan*
and Xiaoqian Lin
Abstract Background: Nowadays, a positive HBV carrier status is common among pregnant women, especially in endemic areas (such as China), little is known about the impact of maternal HBV infection on the risk of adverse pregnancy outcomes. Pregnant women with HBV infection often develop obstetric complications, such as pregnancy-induced hypertension (PIH) syndrome, postpartum hemorrhage, and gestational diabetes mellitus (GDM), and their infants often exhibit neonatal complications. Methods: This study undertook a retrospective cohort analysis to explore the association of HBV carrier status with adverse pregnancy outcomes. A cohort of 85,190 women including 9699 HBsAg-positive and 73,076 HBsAgnegative pregnancies was retrospectively analyzed. Results: It’s found that HBsAg-positive pregnancies may result in higher risk of various maternal outcomes such as ICP (OR 3.4,95%CI 2.80 to 4.13), postpartum hemorrhage (OR 1.16,95%CI 1.00 to 1.34). Interestingly, there was a decreased risk of Preeclampsia (OR 0.91,95%CI 0.87 to 0.96), premature rupture of membrane (OR 0.91,95%CI 0.87 to 0.96) and gestational hypertension (OR 0.828,95%CI 0.701 to 0.978). And in vaginal delivery subgroup analysis, It’s found that the HBsAg-positive group had a higher risk of placental abruption (OR, 1.44; 95% CI, 1.16–1.79). Conclusions: The present results suggest that compared with HBV positive pregnancies were more likely to be ICP and postpartum hemorrhage. HBV-positive pregnant women underwent vaginal delivery were more likely to have placental abruption and premature birth compared with HBV-negative women. Obstetricians should be aware of ICP, postpartum hemorrhage, placental abruption and premature birth in HBV-positive pregnant women. Keywords: HBV infection, Adverse pregnancy outcomes
Background Chronic hepatitis B virus (HBV) infection is an important global health problem. Up to 600,000 of the 350– 400 million carriers of HBV worldwide die annually of chronic hepatitis B (CHB)-related disease [1]. Women of childbearing age who are infected with HBV tend to be in the immune-tolerant or immune-active phases of * Correspondence: [email protected] Department of Obstetrics and Gynecology, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, China
chronic HBV infection and have high levels of viremia. The prevalence of HBV infection among these women may be as high as 0.4% in the USA [2] and 2–8% in China [3–5]. Most pregnant women with HBV infection are chronic carriers of the virus, which can be detected by the presence of the hepatitis B surface antigen (HBsAg) in serum. Although a positive HBV carrier status is common among pregnant women, especially in endemic areas (such as China), little is known about the impact of materna
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