Maternal hepatitis B infection status and adverse pregnancy outcomes: a retrospective cohort analysis
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MATERNAL-FETAL MEDICINE
Maternal hepatitis B infection status and adverse pregnancy outcomes: a retrospective cohort analysis Kaiqi Wu1 · Hong Wang1 · Shuai Li1 · Hong Zhang1 · Bo Zhu1 Received: 28 March 2020 / Accepted: 30 May 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To investigate the association between maternal HBsAg-positive status and pregnancy outcomes. Methods The study enrolled women with singleton pregnancies who delivered during January–December 2018. Data of maternal demographics and main adverse pregnancy outcomes were collected from the institutional medical records and analyzed by univariate and multivariate logistic regression models to determine the association between maternal HBV markers (HBsAg/HBeAg/HBV-DNA loads status) and adverse pregnancy outcomes. Results Total 1146 HBsAg-positive and 18,354 HBsAg-negative pregnant women were included. After adjusting for potential confounding variables, maternal HBsAg-positive status was associated with a high risk of gestational diabetes mellitus (GDM) [adjusted odds ratio (aOR) = 1.24; 95% confidence interval (CI) 1.07–1.43], intrahepatic cholestasis of pregnancy (ICP) (aOR = 3.83; 95% CI 3.14–4.68), preterm birth (aOR = 1.42; 95% CI 1.17–1.72), and neonatal asphyxia (aOR = 2.20; 95% CI 1.34–3.63). Further, higher risks of ICP and neonatal asphyxia remained with either HBeAg-positive status (aOR = 1.64; 95% CI 1.10–2.44; aOR = 3.08; 95% CI 1.17–8.00) or high HBV-DNA load during the second trimester (aOR = 1.52; 95% CI 1.06–2.35; aOR = 4.20; 95% CI 4.20–15.83) among HBsAg-positive pregnant women. Conclusion Women with maternal HBsAg-positive status may have increased risks of GDM, ICP, preterm birth, and neonatal asphyxia; furthermore, the risks of ICP and neonatal asphyxia were higher in women with HBeAg-positive status and a high HBV-DNA load during the second trimester among the HBsAg-positive pregnant women, implying that careful surveillance for chronic HBV infection during pregnancy is warranted. Keywords Hepatitis B virus infection · Pregnancy outcomes · Intrahepatic cholestasis of pregnancy · Neonatal asphyxia
Background Hepatitis B virus (HBV) infection remains a major public health concern, with approximately 257 million people being chronically infected with this virus globally [1]. However, the global prevalence of HBV infection differs greatly, with it being concentrated in Asia and Africa [2]. In China, chronic HBV infection is highly endemic, with > 130 million patients diagnosed with chronic HBV infection [3, 4]. In addition, the prevalence rate of hepatitis B surface antigen (HBsAg) during pregnancy is 7.2% [5]. Hence, most Kaiqi Wu and Hong Wang contributed equally. * Bo Zhu [email protected] 1
School of Medicine, Women’s Hospital, Zhejiang University, Hangzhou, China
pregnant women with HBV infection in China were identified as chronic HBV carriers, which needs pertinent clinical attention. Pregnant women with chronic HBV infection or maternal HBsAg carriers experience a state of
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