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Erschienen in:
23.07.2020 | Maternal-Fetal Medicine
Maternal hepatitis B infection status and adverse pregnancy outcomes: a retrospective cohort analysis
Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 3/2020
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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.