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Abstract：
The effect of hepatitis B virus (HBV) replication during pregnancy on the outcomes of pregnancies remains to be elucidated.
This study aimed to investigate the association between HBV replication and adverse maternal and infant outcomes.
We retrospectively analysed the clinical data of 836 pregnant inpatients with hepatitis B surface antigen positivity who delivered at two provincial tertiary grade A hospitals in the Fujian province between June 2016 and October 2020.
The incidence of intrahepatic cholestasis of pregnancy, hypertensive syndrome complicating pregnancy, gestational diabetes mellitus, preterm birth, macrosomia, growth restriction, and vaginal infections did not differ in the HBV replication and non-replication groups (p > 0.05); however, the rates of caesarean section (p = 0.017; OR, 1.423; 95% CI, 1.065-1.902) and neonatal jaundice (p < 0.001; OR, 2.361; 95% CI, 1.498-3.721) were higher in the replication group than that in the non-replication group. After using propensity score analysis to adjust for alanine transaminase and aspartate aminotransferase levels in both groups, the replication group was still found to have an increased risk for caesarean section (p < 0.001; OR, 2.367; 95% CI, 1.668-3.359) and their infants had higher rates of neonatal jaundice (p < 0.001; OR, 12.605; 95% CI, 4.456-35.656).
Our findings contribute to a better understanding of the association between maternal HBV replication status and perinatal outcomes. Pregnant women with HBV replication face an increased risk of caesarean section, and their infants appear to have a higher risk for neonatal jaundice.
This study aimed to investigate the association between HBV replication and adverse maternal and infant outcomes.
We retrospectively analysed the clinical data of 836 pregnant inpatients with hepatitis B surface antigen positivity who delivered at two provincial tertiary grade A hospitals in the Fujian province between June 2016 and October 2020.
The incidence of intrahepatic cholestasis of pregnancy, hypertensive syndrome complicating pregnancy, gestational diabetes mellitus, preterm birth, macrosomia, growth restriction, and vaginal infections did not differ in the HBV replication and non-replication groups (p > 0.05); however, the rates of caesarean section (p = 0.017; OR, 1.423; 95% CI, 1.065-1.902) and neonatal jaundice (p < 0.001; OR, 2.361; 95% CI, 1.498-3.721) were higher in the replication group than that in the non-replication group. After using propensity score analysis to adjust for alanine transaminase and aspartate aminotransferase levels in both groups, the replication group was still found to have an increased risk for caesarean section (p < 0.001; OR, 2.367; 95% CI, 1.668-3.359) and their infants had higher rates of neonatal jaundice (p < 0.001; OR, 12.605; 95% CI, 4.456-35.656).
Our findings contribute to a better understanding of the association between maternal HBV replication status and perinatal outcomes. Pregnant women with HBV replication face an increased risk of caesarean section, and their infants appear to have a higher risk for neonatal jaundice.
摘要：
■怀孕期间乙型肝炎病毒（HBV）复制对妊娠结局的影响仍有待阐明。
■本研究旨在调查HBV复制与不良母婴结局之间的关联。
我们回顾性分析了2016年6月至2020年10月在福建省两家省级三级甲等医院分娩的836例乙型肝炎表面抗原阳性孕妇住院患者的临床资料。
■妊娠期肝内胆汁淤积症的发病率，妊娠期高血压综合征,妊娠期糖尿病,早产,巨大儿,生长限制，和阴道感染在HBV复制和非复制组中没有差异（p>0.05）;剖腹产率(p=0.017；OR，1.423；95%CI，1.065-1.902）和新生儿黄疸（p<0.001；OR，2.361;95%CI,1.498-3.721)在复制组高于非复制组。在使用倾向评分分析调整两组的丙氨酸转氨酶和天冬氨酸转氨酶水平后，复制组仍然发现剖宫产的风险增加(p<0.001；OR，2.367;95%CI,1.668-3.359),其婴儿新生儿黄疸发生率较高(p<0.001;OR,12.605；95%CI，4.456-35.656）。
■我们的发现有助于更好地理解母体HBV复制状态与围产期结局之间的关联。孕妇HBV复制面临剖宫产的风险增加，他们的婴儿似乎有更高的新生儿黄疸风险。
■本研究旨在调查HBV复制与不良母婴结局之间的关联。
我们回顾性分析了2016年6月至2020年10月在福建省两家省级三级甲等医院分娩的836例乙型肝炎表面抗原阳性孕妇住院患者的临床资料。
■妊娠期肝内胆汁淤积症的发病率，妊娠期高血压综合征,妊娠期糖尿病,早产,巨大儿,生长限制，和阴道感染在HBV复制和非复制组中没有差异（p>0.05）;剖腹产率(p=0.017；OR，1.423；95%CI，1.065-1.902）和新生儿黄疸（p<0.001；OR，2.361;95%CI,1.498-3.721)在复制组高于非复制组。在使用倾向评分分析调整两组的丙氨酸转氨酶和天冬氨酸转氨酶水平后，复制组仍然发现剖宫产的风险增加(p<0.001；OR，2.367;95%CI,1.668-3.359),其婴儿新生儿黄疸发生率较高(p<0.001;OR,12.605；95%CI，4.456-35.656）。
■我们的发现有助于更好地理解母体HBV复制状态与围产期结局之间的关联。孕妇HBV复制面临剖宫产的风险增加，他们的婴儿似乎有更高的新生儿黄疸风险。
