Chronic maternal hepatitis B virus infection and pregnancy outcome- a single center study in Kunming, China

Abstract

Background Chinese population has a high prevalence of chronic hepatitis B virus (HBV) infection, the impact of which on pregnancy outcome remains controversial. A single-center retrospective cohort study was performed in Kunming, a multi-ethnic city in south-western China to examine this issue. Methods The singleton pregnancies delivering at ≥28 weeks gestation under our care in 2005–2017 constituted the study cohort. Maternal characteristics and pregnancy outcome were compared between mothers with and without seropositivity for hepatitis B surface antigen (HBsAg) determined at routine antenatal screening. Results Among the 49,479 gravidae in the cohort, the 1624 (3.3%) HBsAg seropositive gravidae had a lower incidence of nulliparity (RR 0.963, 95% CI 0.935–0.992) and having received tertiary education (RR 0.829, 95% CI 0.784–0.827). There was no significant difference in the medical history, pregnancy complications, or labor or perinatal outcome, except that HBV carriers had significantly lower incidence of labor induction (RR 0.827, 95% CI 0.714–0.958) and of small-for-gestational age (SGA) infants (RR 0.854, 95% CI 0.734–0.994). On regression analysis, maternal HBV carriage was independently associated with spontaneous labor (aRR 1.231, 95% CI 1.044–1.451) and reduced SGA infants (aRR 0.842, 95% CI 0.712–0.997). Conclusions Our 3.3% prevalence of maternal HBV infection was around the lower range determined in the Chinese population. The association with spontaneous labor and reduced SGA infants could have helped to promote the perpetuation of the infection through enhanced survival of the offspring infected at birth, thus explaining the high prevalence in the Chinese population.

Maternal hepatitis B surface antigen carrier status and pregnancy outcome: a retrospective cohort study

“…In this study, we investigated the outcomes of 735 pregnant women with HBsAg carrier status and 18 693 cases in a non-exposed group of subjects in Hangzhou, China. We found that the proportion of positive maternal HBsAg carrier was 3.78%; this was slightly higher than the 3.3% rate reported previously in Kunming, China [ 18 ].…”

Hepatitis B Infection Among Pregnant Women in China: A Systematic Review and Meta-Analysis

“…Three studies (sample size 94,525) indicated that compared to those with HBsAg negative, HBsAg positive women were older ( 16 , 49 , 52 ). Two studies (sample size 132,254) demonstrated that the age was not statistically different between HBsAg positive and negative groups ( 32 , 48 ).…”

“…Ten studies analyzed the relationship between the times of gestation and parity and HBsAg positive rate. Seven studies (sample size 954,199) suggested that HBV prevalence in primigravida and primiparas was lower ( 12 , 13 , 28 , 32 , 48 , 49 , 52 ), while the other three studies (sample size 45,248) showed no relevance ( 16 , 33 , 46 ).…”

“…Four studies presented the relationship between the education level and HBsAg positive rate. Two studies (sample size 782,262) showed that HBV positive rate decreased when education level improved ( 12 , 32 ), and the other two studies (sample size 24,333) demonstrated no relevance ( 13 , 16 ).…”

Prevalence of hepatitis B virus infection among pregnant women in the mountainous regions of southern China: A retrospective single‐center study

“… 23 Similar to other reports, the prevalence of HBV infection was significantly lower in Liaoning (3.08%), 24 Tianjin (3.77%), 25 Shanxi (4.90%), 26 Xinjiang (4.43%), 26 Sichuan (4.24%), 27 and Yunnan (3.28%). 28 The prevalence rate of HBV infection differed among pregnant women in the provinces of China and at different periods. Moreover, recent national epidemiological data showed that the prevalence of HBV infection continuously declined among pregnant women in China.…”