Risk factors for hepatitis B virus infections among pregnant women in East Lombok District

Abstract

Background and objectives: The World Health Organization has set a target of 90% reduction in new Hepatitis B infections by 2030. The program includes prevention of new infections, and increases testing uptake and treatment. In order to effectively foster prevention, it is necessary to understand the risk factors for transmission. This study aims to determine the risk factors of Hepatitis B infection in pregnant women.Method: A case control study was carried out among 52 pregnant women with HBsAg (+) as cases and 104 pregnant women with HBsAg (-) as controls. The source of cases and controls was the register of pregnant women at the Pringgasela Public Health Center from January 2016 to October 2017. Cases were selected using systematic random sampling from 67 HBsAg (+) pregnant women and controls were selected in the same way from 1644 pregnant women with HBsAg (-). Cases and controls were matched by domicile. The data collected were age, age of first marriage, education, family income, parity, history of miscarriage, maternal or husband’s history of working abroad, frequency of marriage, history of injection, surgery, blood transfusion and dental care. Data collection was carried out with a pre-tested questionnaire in April-May 2018 through interviews at the home of each respondent. Multivariate analysis with logistic regression was carried out to determine the adjusted odds ratio of each risk factor.Results: Case and control characteristics were found to be similar in terms of age, domicile, education and income. Significant risk factors were the history of husband working abroad (AOR=4,115; 95%CI: 1,657-11,075), age of first marriage <20 years (AOR=2,420; 95%CI: 1,157-5,481) and frequency of husband's marriage more than one time (AOR=3,081; 95%CI: 1,345-7,080).Conclusion: Husbands with history of working abroad, age of first marriage <20 years and frequency of husband's marriage more than one time were found to be the risk factors for Hepatitis B infection in pregnant women. These factors require public health attention in order to reduce the transmission of Hepatitis B.

Determinant Analysis Risk Factors Incidence of Hepatitis B Virus Infection at Pregnant Women

“…Age variable were statistically significant related to the incidence of hepatitis B virus infection in pregnancy with a p value of 0.000 and OR 0.244 meaning that pregnant women aged <16 and > 40 years 76% were spared Hepatitis B virus infection than pregnant women aged 16-40 years. The results of this study are in line with research in (Lombok) reported 63.4% of pregnant women with HBV aged 25-34 years (Faizaturrahmi et al, 2018) The results of this study are in line with several studies in various countries, including research in China which states that the age of mothers who experience the most hepatitis B is 247 people (5.64%) at the age> 20 years and at 4.54 times the risk of being infected with HBV compared to mothers at age <20 year (Ding et al, 2013). At United States, 4391 pregnant women with unknown hepatitis occurred at the age of the group, namely 2572 (59%) in the 26-25 year age group, 1038 (24%) aged ≤ 25 years and 781 (18%) aged> 35 years (Bajema et al, 2018).…”

“…This result is not in line with a study in Iran that found 5.72% of HBV cases in pregnant women with a previous abortion risk (Afzali et al, 2015), a study in China of 15 women with a history of previous abortions ≥ 2 times. (Cui et al, 2016) As well as research in Indonesia (East Lombok) which found 17.3% of mothers infected with HBV had had an abortion (Faizaturrahmi et al, 2018). The results of this study are not in line with the 2015 Noubiap study which stated that blood transfusion is one of the variables associated with HBV infection (Noubiap et al, 2015).…”

“…The results of this study are in line with several studies which reported that pregnant women infected with HBV were multiparous mothers (61.82%) (China) (Huang et al, 2014), 11 people (46.67%), 23 people (20.7%). (Nigeria) (Access, 2015) (Kolawole et al 2012), 55% with parity status ≥ 1 child (United States) (Bajema et al, 2018), 57.7% with parity ≥2 with p value 0.001 (Indonesia) (Faizaturrahmi et al, 2018). Although it is not directly related as a causal relationship, high parity ≥ 1 has less good health conditions than low parity <1 child.…”

Faktor Risiko Hepatitis B pada Ibu Hamil di Kota Semarang Tahun 2020-2021 (Studi Kasus di Puskesmas Genuk & Puskesmas Bangetayu)

“…Penelitian ini memiliki hasil yang serupa dengan penelitian Surapathi (21) di Karangasem, Bali, di mana ibu yang menikah di bawah usia 19 tahun berisiko 2,5 kali terinfeksi hepatitis B dibandingkan ibu yang menikah di atas usia 19 tahun dengan p value sebesar 0,024. Begitu juga dengan penelitian Faizaturrahmi (22) di Kabupaten Lombok Timur yang menemukan bahwa ibu yang menikah pada usia kurang dari 19 tahun berisiko 2,3 kali lebih besar terinfeksi hepatitis B dibandingkan dengan responden yang menikah lebih dari 19 tahun dengan p value sebesar 0,02. Usia pernikahan juga berhubungan dengan tingkat pendidikan mereka, semakin dewasa usia saat pertama menikah, maka semakin tinggi tingkat pendidikannya, begitu juga sebaliknya.…”

“…Perempuan yang menikah di usia dini kurang mampu menegosiasikan seks yang aman, sehingga menyebabkan meningkatnya kerentanan terhadap penyakit menular seksual. Ditambah dengan tingkat pendidikan yang rendah yang menyebabkan pengetahuan yang rendah mengenai kesehatan reproduksi (22).…”