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Maternal hepatitis B infection status and adverse pregnancy outcomes: a retrospective cohort analysis

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

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.

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Funding

This work has been funded by Zhejiang Medical Health Science and Technology Project (No. 2017203230).

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Author notes

  1. Kaiqi Wu and Hong Wang contributed equally.

Authors and Affiliations

  1. School of Medicine, Women’s Hospital, Zhejiang University, Hangzhou, China

    Kaiqi Wu, Hong Wang, Shuai Li, Hong Zhang & Bo Zhu

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  1. Kaiqi Wu
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  2. Hong Wang
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Contributions

KW: literature review, investigation, data collection and analysis, and writing (original draft). HW: literature review, investigation, data collection and analysis, writing (review/edits), and funding acquisition. SL: literature review, investigation, data collection, and writing (review/edits). HZ: literature review, investigation, data collection, and writing (review/edits). BZ: conceptualization, investigation, data collection and analysis, funding acquisition, supervision, validation, and writing (review/edits).

Corresponding author

Correspondence to Bo Zhu.

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The authors declare that they have no conflict of interest.

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This study was approved by the Medical Ethics Committee of Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China (Approval number: IRB-20200063-R).

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Wu, K., Wang, H., Li, S. et al. Maternal hepatitis B infection status and adverse pregnancy outcomes: a retrospective cohort analysis. Arch Gynecol Obstet 302, 595–602 (2020). https://doi.org/10.1007/s00404-020-05630-2

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