Spontaneous preterm birth in women with chronic hepatitis B virus infection

Elefsiniotis, Ioannis; Tsoumakas, Konstantinos; Vezali, Elena; Glynou, Irene; Drakoulis, Nikolaos; Saroglou, George

doi:10.1016/j.ijgo.2010.04.020

Cited by 31 publications

(30 citation statements)

References 19 publications

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“…Increased insulin resistance in this instance is probably related to viral activity, as it could be reduced following successful treatment with interferon‐α [41]. From the example of preterm birth [17], it is likely that the extent of obstetric complications is similarly related to viral activity, so that the majority of women with low viral activity would have ‘normal’ glucose tolerance and no treatment. In fact, the risk of macrosomia in treated women with GDM was less than half (8.0% vs. 17.4%) of the normal women with glucose tolerance test results just below the threshold of diagnosis [42], and treatment for GDM effectively reduced the incidence of large babies [42,43].…”

Section: Discussionmentioning

confidence: 99%

Maternal HBsAg status and infant size – a Faustian bargain?

Lao

Sahota

Suen

et al. 2012

Journal of Viral Hepatitis

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Information on the impact of maternal hepatitis B virus (HBV) infection on pregnancy outcome is conflicting. Some studies reported an association with increased infant birthweight, which could be interpreted as advantageous to pregnancy. A retrospective study was performed to compare birthweight outcome between 6261 and 55,817 singleton pregnancies in mothers screened positive and negative for hepatitis B surface antigen (HBsAg), respectively. The HBsAg positive women were younger, had higher body mass index (BMI) and incidence of overweight, but less gestational weight gain, and were associated with increased macrosomia (birthweight ≥4000 g) in mothers <35 years (odds ratio, OR, 1.28), BMI ≥25 kg/m(2) (OR 1.24), without gestational diabetes mellitus (GDM, OR 1.19), and in male infants (OR 1.18). It was also associated with increased large-for-gestational age (LGA, birthweight >90th percentile) infants in nulliparas (OR 1.13), age <35 years (OR 1.12), BMI ≥25 kg/m(2) (OR 1.19), with (OR 1.36) and without (OR 1.09) GDM, and in male infants (OR 1.13). When the effects of high BMI, advanced age, GDM, and male infants were controlled for, positive HBsAg was significantly associated with macrosomic (adjusted odds ratio, aOR, 1.15) and LGA (aOR 1.11) infants. In view of the latest findings on the association between high infant birthweight with increased risk of obesity, diabetes mellitus, and various forms of malignancies from childhood to adulthood, further studies are warranted to determine if maternal hepatitis B infection would impact adversely on the long-term health of the offspring through its effect on increasing birthweight.

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Section: Discussionmentioning

confidence: 99%

Maternal HBsAg status and infant size – a Faustian bargain?

Lao

Sahota

Suen

et al. 2012

Journal of Viral Hepatitis

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“…Consequently, maternal HBV infection should be one of the commonest infections encountered during pregnancy, yet its impact on pregnancy outcome remains unclear. While maternal asymptomatic infection with HBV, as indicated by the detection of hepatitis B surface antigen (HBsAg) at antenatal screening, has been associated with increased antepartum haemorrhage, gestational diabetes mellitus, preterm birth, and foetal growth restriction and demise [6][7][8][9][10][11][12][13], other studies found no such association [14][15][16][17]. One intriguing finding was on the occurrence of pregnancy-induced hypertension (PIH) or pre-eclampsia (PE).…”

Section: Introductionmentioning

confidence: 99%

Maternal hepatitis B surface antigen status and incidence of pre‐eclampsia

Lao

Sahota

Cheng

et al. 2013

Journal of Viral Hepatitis

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The relationship between chronic hepatitis B virus (HBV) infection with atherosclerosis and cardiovascular disorders remains unclear, and the impact of maternal HBV infection on the development of pregnancy-induced hypertension (PIH) and pre-eclampsia (PE) is also controversial. This retrospective cohort study was conducted to examine the relationship between maternal hepatitis B surface antigen (HBsAg) status with PIH and PE in singleton pregnancies that delivered at 24 weeks of gestation and beyond. Among the 86 537 cases in the cohort, 10% were HBsAg positive, and overall 2.0% had PIH, of whom 56.3% developed PE. HBsAg-positive women had higher weight and body mass index (BMI), but lower incidences of advanced age, nulliparity, PIH (1.6% vs 2.0%, P = 0.007) and PE (0.8% vs 1.1%, P = 0.005). On multiple logistic regression analysis adjusting for the effects of nulliparity, advanced age, high BMI, and underlying renal, cardiac and autoimmune diseases, HBsAg carriage was associated with significantly reduced incidence of PIH (aOR 0.79, 95% CI 0.66-0.95) and PE (aOR 0.71, 95% CI 0.56-0.91). Our results indicate that maternal HBsAg carriage is independently associated with reduced PE. As chronic HBV infection alters the immune response of the individual, our observation could be related to enhanced maternal immunotolerance of the foetus and hence a reduction in the incidence of PE. The implications of our findings on the long-term health outcome of the infected women, from cardiovascular morbidity to malignancies, warrant further studies.

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“…In this context, while lack of any significant differences was reported in terms of gestational age at delivery, birth weight, incidence of prematurity, neonatal jaundice, congenital anomalies and perinatal mortality in HBsAg-positive women when compared to controls (17), retrospective evaluation of chronic maternal HBV infection on pregnancy outcome revealed that a chronic HBV infection in the pregnant woman may contribute to premature birth because of low grade inflammation due to the release of pro-inflammatory cytokines (7,17). Whilst still subject to further investigation, pregnancy outcome in our case supports the suggested association of pregnancy of a mother with chronic HBV infection with preterm delivery (5,17).…”

Section: Discussionmentioning

confidence: 97%

“…Nevertheless, much has been documented about peri-natal mother to newborn transmission of HBV and the possible modes of prevention, but data concerning the effect of chronic maternal infection on pregnancy outcome as well as the effect of pregnancy on maternal HBV disease in the chronically infected mothers are limited and controversial (3,4,7). From this point of view, this paper presents the outcome of pregnancy in a patient with chronic hepatitis B infection who was administered tenofovir disoproxil fumarate (TDF; 245 mg/day) monotherapy at the 32 nd gestational week due to risks related to high viral load.…”

Section: Introductionmentioning

confidence: 99%