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

Chen, Yiming; Ning, Wenwen; Wang, Xue; Chen, Yijie; Wu, Bin; Tao, Jie

doi:10.1017/s0950268822000681

Cited by 7 publications

(12 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The study also found no association between preterm delivery, premature rupture of membranes, cesarean section, meconium-stained amniotic fluidis and HBV infection, consistent with studies ( 7 , 9 , 33 , 34 ). Interestingly, it has been shown in some studies ( 35–37 ) that maternal HBsAg carriers may have an increased risk of preterm birth.…”

Section: Discussionsupporting

confidence: 89%

“…In this field, there are few reports on the association between HBsAg carriers and pregnancy complications and the relationship between them is unclear. Chen et al reported that HBsAg-positive pregnant women have an increasing risk of intrahepatic cholestasis of pregnancy (ICP), low birth weight, fallopian cysts, cesarean scar pregnancy, thrombocytopenia, and fetal distress ( 7 ). Wan et al found that maternal HBsAg carrying was associated with increasing risk of pregnancy-induced hypertension, fetal distress, cesarean delivery and macrosomia ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of HBsAg carriers on pregnancy complications in pregnant women: a retrospective cohort study

Weng

Wang²,

Yin³

et al. 2023

Front. Med.

View full text Add to dashboard Cite

ObjectiveHepatitis B virus (HBV) infection is a major health threat worldwide, especially in developing countries. We aimed to investigate the impact of hepatitis B carrier on pregnancy complications in pregnant women, in China.MethodsThis retrospective cohort study was conducted by using data from the EHR system of Longhua District People’s Hospital in Shenzhen, China, from January 2018 to June 2022. Binary logistic regression was used to evaluate the relationship between HBsAg carrier status and pregnancy complications and pregnancy outcomes.ResultsThe study included 2095 HBsAg carriers (exposed group) and 23,019 normal pregnant women (unexposed group). Pregnant women in the exposed group were older than the pregnant women in the unexposed group (29 (27,32) vs. 29 (26,32), p < 0.001). In addition, the incidence of some adverse pregnancy complications in the exposure group was lower than that in the unexposed group, including hypothyroidism of pregnancy (adjusted odds ratio [aOR], 0.779; 95% confidence interval [CI], 0.617–0.984; p = 0.036), hyperthyroidism of pregnancy (aOR, 0.388; 95% CI, 0.159–0.984; p = 0.038), pregnancy induced hypertension (aOR, 0.699; 95% CI, 0.551–0.887; p = 0.003), antepartum hemorrhage (aOR, 0.294; 95% CI, 0.093–0.929; p = 0.037). However, compared with the unexposed group, the exposed group had a higher risk of lower birth weight (aOR, 1.12; 95% CI, 1.02–1.23; p = 0.018) and intrahepatic cholestasis of pregnancy (aOR, 2.888, 95% CI, 2.207–3.780; p < 0.001).ConclusionThe prevalence rate of HBsAg carriers in pregnant women in Longhua District of Shenzhen was 8.34%. Compared with normal pregnant women, HBsAg carriers have a higher risk of ICP, a lower risk of gestational hypothyroidism and PIH, and a lower birth weight of their infants.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Effects of HBsAg carriers on pregnancy complications in pregnant women: a retrospective cohort study

Weng

Wang²,

Yin³

et al. 2023

Front. Med.

View full text Add to dashboard Cite

show abstract

“…Similarly, Cai et al [ 26 ] showed that chronic HBV infection during pregnancy may increase ICP (aOR = 1.700) and that pregnant women with an HBeAg-positive (aOR = 2.960) or HBeAg-negative (aOR = 1.520) status still have the risk of ICP. Our previous study also found that HBsAg-positive pregnant women in Hangzhou, China have a higher risk of ICP (aOR = 3.169) [ 19 ]. These studies demonstrated that pregnant women who were carriers of hepatitis B were more likely to develop ICP.…”

Section: Discussionmentioning

confidence: 95%

“…Univariate analysis of qualitative or quantitative data was performed using the Chi-Squared test or Mann–Whitney U test, with P < 0.10 as the selection criteria for multivariate binary logistic regression analysis. Multivariate binary logistic regression analysis was used to screen the variable odds ratio (OR) and 95% confidence interval (CI) of each relevant influencing factor, adjusted odds ratio (aOR), after adjusting for potential confounding variables (Backward: Likelihood Ratio Test (LR): Based on all candidate variables, the independent variables that do not meet the requirements of the significant retention level are eliminated from the model at one time, and the remaining variables are entered into the model [ 19 ]). The variable input in step 1 included: before the occurrence of ICP: gravidity ≥ 1, parity ≥ 1, hypertensive disorders of pregnancy (HDP) [gestational hypertension (GH), preeclampsia (PE)], hyperlipidemia, gestational diabetes mellitus (GDM), anemia, thrombocytopenia, hepatitis B virus carriers, BMI (Categories); after the occurrence of ICP: premature rupture of membranes (PPROM), fetal growth retardation, preterm birth, gestational days (Categories), caesarean section, infant sex (female), infant length (cm), infant weight (Categories).…”

Section: Methodsmentioning

confidence: 99%

The impact of intrahepatic cholestasis on pregnancy outcomes: a retrospective cohort study

et al. 2023

View full text Add to dashboard Cite

Background This study analyzed the pregnancy outcomes of patients with intrahepatic cholestasis of pregnancy (ICP) in Hangzhou, China. Methods Cases of pregnant women monitored by antepartum testing at Hangzhou Women’s Hospital from January 2018 to December 2020 were reviewed. Subjects were classified into two groups according to whether they had ICP: 688 cases of ICP were assigned to an exposure group while 38,556 cases of non-ICP were assigned to a non-exposed group. Univariate analysis was performed on qualitative or quantitative data using the Chi-Squared test or Mann–Whitney U test, and the adjusted odds ratio (aOR) and 95% confidence interval (CI) of the two groups of related variables were calculated by multivariate binary logistic regression analysis. Results The incidence rate of ICP was 1.75%. Pregnant women with hepatitis B virus were correlated with ICP. Hepatitis B carriers (aOR = 3.873), preeclampsia (PE, aOR = 3.712), thrombocytopenia (aOR = 1.992), gestational hypertension (GH, aOR = 1.627), hyperlipidemia (aOR = 1.602) and gestational diabetes mellitus (GDM, aOR = 1.265) were all risk factors for ICP. In contrast, Body Mass Index (BMI) ≥ 30 kg/m2 (aOR = 0.446), 25 m2 < maternal BMI < 29.9 kg/m2 (aOR = 0.699) and parity ≥ 1 (aOR = 0.722) were protective factors for ICP. Pregnant women in the ICP group had an increased risk of gestation days < 259 days (aOR = 4.574) and cesarean delivery (aOR = 1.930) after ICP, and a decreased risk of longer gestational days (aOR = 0.105), premature rupture of membranes (aOR = 0.384) and fetal macrosomia (aOR = 0.551). Conclusions By analyzing a Chinese population with ICP, we identified that pregnant women who are hepatitis B carriers or with PE, thrombocytopenia, GH, hyperlipidemia, and GDM are at higher risk of ICP. Moreover, ICP is associated with adverse pregnancy outcomes; in particular, ICP may increase the incidence of shorter gestational days and non-vaginal delivery methods such as cesarean section but reduce the incidence of premature rupture of membranes and fetal macrosomia.

show abstract

“…Hepatitis B virus (HBV) carrier status was defined as the hepatitis B surface antigen (HBsAg) seropositive on serological testing, 1 which is a major public health problem around the world. It has a high risk of death from hepatic diseases, such as cirrhosis and hepatocellular cancer.…”

Section: Introductionmentioning

confidence: 99%

Impact of maternal hepatitis B carrier status on congenital abnormalities: a systematic review and meta-analysis

et al. 2023

View full text Add to dashboard Cite

ObjectivesThis study aims to explore whether maternal hepatitis B carrier status is associated with an increased risk of congenital abnormalities.DesignA systematic review and meta-analysis of observational studies.Data sourcesPubMed, Embase (Ovid), Scopus, the China National Knowledge Infrastructure (CNKI) and the Wanfang databases.Study selectionFive databases were searched systematically from inception to 7 September 2021. Cohort and case–control studies that investigated the association between maternal hepatitis B virus (HBV) infection and congenital abnormalities were included. This study was conducted according to MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines.Data extraction and synthesisTwo reviewers independently collected data, as well as assessed risk of bias by using Newcastle–Ottawa Scale. We pooled crude relative risk (cRR) and adjusted OR (aOR) by DerSimonian-Laird random-effects model. Heterogeneity was explored byI2statistics, Cochran’s Q test. Several subgroup analyses and sensitivity analyses were performed.ResultsIn total, 14 studies involving 16 205 pregnant women exposed to HBV were included. The pooled cRR of 1.15 (95% CI: 0.92 to 1.45; 14 studies included) showed a marginal but not significant association between maternal HBV-carrier status and congenital abnormalities. However, the pooled aOR of 1.40 (95% CI: 1.01 to 1.93; 8 studies included) indicated that pregnant women with HBV infection might be associated with a higher risk of congenital abnormalities. Subgroup analyses of adjusted data showed a higher pooling cRR or aOR on high prevalence HBV infection populations, as well as studies from Asia and Oceania.ConclusionsMaternal hepatitis B carrier status might be at potential risk for congenital abnormalities. The existing evidence was not sufficient to draw a firm conclusion. Additional studies may be warranted to confirm the association.PROSPERO registration numberCRD42020205459.

show abstract

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

Cited by 7 publications

References 27 publications

Effects of HBsAg carriers on pregnancy complications in pregnant women: a retrospective cohort study

Effects of HBsAg carriers on pregnancy complications in pregnant women: a retrospective cohort study

The impact of intrahepatic cholestasis on pregnancy outcomes: a retrospective cohort study

Impact of maternal hepatitis B carrier status on congenital abnormalities: a systematic review and meta-analysis

Contact Info

Product

Resources

About