Association of gestational hepatitis B virus infection and antiviral therapy with pregnancy outcomes: A retrospective study.

Autor: Mao K; Department of Gastroenterology, Fujian Medical University Union Hospital, Fuzhou, China., Jiang P; Department of Gastroenterology, Fujian Medical University Union Hospital, Fuzhou, China., Cai W; Department of Gastroenterology, Fujian Medical University Union Hospital, Fuzhou, China., Lin Y; Department of Gastroenterology, Fujian Medical University Union Hospital, Fuzhou, China., Zhou Y; Department of Obstetrics and Gynecology, Fujian Medical University Union Hospital, Fuzhou, China., Li D; Department of Gastroenterology, Fujian Medical University Union Hospital, Fuzhou, China.; Fujian Clinical Research Center for Digestive System Tumors and Upper Gastrointestinal Diseases, Fuzhou, China.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2024 Jul; Vol. 166 (1), pp. 115-125. Date of Electronic Publication: 2024 Jun 04.
DOI: 10.1002/ijgo.15716
Abstrakt: Objective: To explore the relationships between gestational hepatitis B virus (HBV) infection, antiviral therapy, and pregnancy outcomes.
Methods: We retrospectively selected hepatitis B surface antigen (HBsAg)-positive pregnant women hospitalized for delivery at Fujian Medical University Affiliated Hospital from October 1, 2016 to October 1, 2020. The control group included randomly selected healthy pregnant women hospitalized for delivery during the same time.
Results: Overall, 1115 participants were enrolled and grouped into control (n = 380) and HBsAg-positive groups (n = 735), which were further divided into groups I (n = 407; low viral load), II (n = 207; high viral load without antiviral therapy), and III (n = 121; high viral load with antiviral therapy). Pregnant women with HBV were positively correlated with the incidence of intrahepatic cholestasis of pregnancy (ICP) (adjusted odds ratio [aOR] 5.1, 95% confidence interval [CI] 2.62-9.92, P < 0.001), neonatal jaundice (aOR 10.56, 95% CI 4.49-24.83, P < 0.001), and neonatal asphyxia (aOR 5.03, 95% CI 1.46-17.27, P = 0.01). Aspartate aminotransferase (AST) greater than the upper limit of normal (ULN) was an independent risk factor for increased ICP incidence (aOR 3.49, 95% CI 1.26-9.67, P = 0.019). Antiviral therapy considerably reduced HBV DNA and improved liver function. High viral load and antiviral therapy did not correlate significantly with adverse pregnancy outcomes (P < 0.05).
Conclusion: Pregnant women with HBV have significantly elevated incidence of ICP, neonatal jaundice, and neonatal asphyxia not significantly correlated with viral load. AST greater than ULN independently increases the risk of ICP. Antiviral therapy effectively reduces viral replication and improves liver function without increasing the risk of adverse outcomes.
(© 2024 International Federation of Gynecology and Obstetrics.)
Databáze: MEDLINE
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