Abstract：
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).
CONCLUSIONS: 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.
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).
CONCLUSIONS: 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.
摘要：
目的:探讨妊娠期乙型肝炎病毒(HBV)感染的关系,抗病毒治疗,和妊娠结局。
方法：回顾性选择2016年10月1日至2020年10月1日在福建医科大学附属医院住院分娩的乙肝表面抗原（HBsAg）阳性孕妇。对照组为随机选取同期住院分娩的健康孕妇。
结果：总体而言，1115名参与者被纳入并分组为对照组（n=380）和HBsAg阳性组（n=735），进一步分为I组（n=407；低病毒载量），II（n=207；无抗病毒治疗的高病毒载量），和III（n=121；抗病毒治疗的高病毒载量）。HBV孕妇与妊娠肝内胆汁淤积症（ICP）的发生率呈正相关（调整比值比[aOR]5.1，95％置信区间[CI]2.62-9.92，P<0.001），新生儿黄疸(aOR10.56,95%CI4.49-24.83,P<0.001),和新生儿窒息（aOR5.03，95％CI1.46-17.27，P=0.01）。天冬氨酸转氨酶(AST)高于正常值上限(ULN)是ICP发生率升高的独立危险因素(aOR3.49,95%CI1.26~9.67,P=0.019)。抗病毒治疗显着降低HBVDNA和改善肝功能。高病毒载量和抗病毒治疗与不良妊娠结局无显著相关性(P<0.05)。
结论：HBV孕妇的ICP发病率显著升高，新生儿黄疸,新生儿窒息与病毒载量无显著相关性。AST大于ULN独立地增加ICP的风险。抗病毒治疗可有效减少病毒复制并改善肝功能，而不会增加不良后果的风险。
方法：回顾性选择2016年10月1日至2020年10月1日在福建医科大学附属医院住院分娩的乙肝表面抗原（HBsAg）阳性孕妇。对照组为随机选取同期住院分娩的健康孕妇。
结果：总体而言，1115名参与者被纳入并分组为对照组（n=380）和HBsAg阳性组（n=735），进一步分为I组（n=407；低病毒载量），II（n=207；无抗病毒治疗的高病毒载量），和III（n=121；抗病毒治疗的高病毒载量）。HBV孕妇与妊娠肝内胆汁淤积症（ICP）的发生率呈正相关（调整比值比[aOR]5.1，95％置信区间[CI]2.62-9.92，P<0.001），新生儿黄疸(aOR10.56,95%CI4.49-24.83,P<0.001),和新生儿窒息（aOR5.03，95％CI1.46-17.27，P=0.01）。天冬氨酸转氨酶(AST)高于正常值上限(ULN)是ICP发生率升高的独立危险因素(aOR3.49,95%CI1.26~9.67,P=0.019)。抗病毒治疗显着降低HBVDNA和改善肝功能。高病毒载量和抗病毒治疗与不良妊娠结局无显著相关性(P<0.05)。
结论：HBV孕妇的ICP发病率显著升高，新生儿黄疸,新生儿窒息与病毒载量无显著相关性。AST大于ULN独立地增加ICP的风险。抗病毒治疗可有效减少病毒复制并改善肝功能，而不会增加不良后果的风险。
