The impact of intrahepatic cholestasis of pregnancy with hepatitis B virus infection on perinatal outcomes

Hu, Yun; Ding, Yiling; Yu, Ling

doi:10.2147/tcrm.s61530

Cited by 14 publications

(13 citation statements)

References 20 publications

(23 reference statements)

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“…Interestingly, there was a significant difference between the HBV-infected and the normal groups regarding mode of delivery. Here, a decreased risk of premature rupture of fetal membranes was observed in HBV-infected women compared with the normal group, whereas a previous report describes opposite findings [ 31 ]. These results suggest that HBV-infected pregnant women may maintain a good self-management level and obtain additional help from their physicians and families.…”

Section: Discussioncontrasting

confidence: 50%

Maternal HBsAg carriers and pregnancy outcomes: a retrospective cohort analysis of 85,190 pregnancies

Zhang

Chen

Liao

et al. 2020

BMC Pregnancy Childbirth

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Background Nowadays, a positive HBV carrier status is common among pregnant women, especially in endemic areas (such as China), little is known about the impact of maternal HBV infection on the risk of adverse pregnancy outcomes. Pregnant women with HBV infection often develop obstetric complications, such as pregnancy-induced hypertension (PIH) syndrome, postpartum hemorrhage, and gestational diabetes mellitus (GDM), and their infants often exhibit neonatal complications. Methods This study undertook a retrospective cohort analysis to explore the association of HBV carrier status with adverse pregnancy outcomes. A cohort of 85,190 women including 9699 HBsAg-positive and 73,076 HBsAg-negative pregnancies was retrospectively analyzed. Results It’s found that HBsAg-positive pregnancies may result in higher risk of various maternal outcomes such as ICP (OR 3.4,95%CI 2.80 to 4.13), postpartum hemorrhage (OR 1.16,95%CI 1.00 to 1.34). Interestingly, there was a decreased risk of Preeclampsia (OR 0.91,95%CI 0.87 to 0.96), premature rupture of membrane (OR 0.91,95%CI 0.87 to 0.96) and gestational hypertension (OR 0.828,95%CI 0.701 to 0.978). And in vaginal delivery subgroup analysis, It’s found that the HBsAg-positive group had a higher risk of placental abruption (OR, 1.44; 95% CI, 1.16–1.79). Conclusions The present results suggest that compared with HBV positive pregnancies were more likely to be ICP and postpartum hemorrhage. HBV-positive pregnant women underwent vaginal delivery were more likely to have placental abruption and premature birth compared with HBV-negative women. Obstetricians should be aware of ICP, postpartum hemorrhage, placental abruption and premature birth in HBV-positive pregnant women.

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Section: Discussioncontrasting

confidence: 50%

Maternal HBsAg carriers and pregnancy outcomes: a retrospective cohort analysis of 85,190 pregnancies

Zhang

Chen

Liao

et al. 2020

BMC Pregnancy Childbirth

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“…In a previous study conducted by Tse et al, [ 31 ] a high risk of antepartum hemorrhage had been identified to be associated with HBV infection, which may be related to the chronic inflammatory state in this population. The close association of ICP with HBV has also been explored in other observations, [ 32 ] and the inflammation caused by chronic HBV infection was responsible for this. Thrombocytopenia and anemia are the common complications in patients with liver stiffness.…”

Section: Discussionmentioning

confidence: 83%

Different interventional criteria for chronic hepatitis B pregnant women with HBeAg(+) or HBeAg(-)

Chen¹,

Wang

Qiu

et al. 2018

Medicine

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The seroprevalence of hepatitis B virus (HBV) and its impact on pregnancy outcomes of women from Shaanxi Province (China) was assessed. Risk factors for mother-to-child transmission (MTCT) were evaluated based on HBV-related seroprevalence data.Viral markers and biochemical parameters were assessed in HBsAg-positive mothers and their infants out of 13,451 cases recruited. A pretested and structured questionnaire was used to test the general HBV knowledge. Descriptive statistics and logistic regression analysis were done to reveal possible risk factors for MTCT.The overall prevalence of HBsAg in pregnant women was 7.07% (951/13,451), and a rate as high as 9.40% was observed. Among the HBsAg-positive pregnant women, 30.49% (290/951) were HBeAg-positive, 22.08% (210/951) had HBV DNA levels >106 IU/mL and only 16.19% with a high risk of MTCT (34/210) had received antiviral treatment. The overall MTCT rate was 5.21%. Noteworthy, the risk ratio and 95% confidence interval (95% CI) of MTCT in HBeAg-negative mothers with HBV DNA levels >2 × 103 IU/mL and HBsAg >104 IU/mL was 26.062 (2.633–258.024), which was significantly higher than that of HBeAg-positive mothers with HBV DNA level >106 IU/mL. Moreover, the awareness and knowledge about HBV transmission, risk factors, and intervention for MTCT were generally lacking among HBsAg-positive mothers.As a higher HBsAg seroprevalence and a higher MTCT rate among HBeAg-negative mothers with lower HBV DNA level was observed, our study emphasizes different interventional criteria for HBeAg-positive and HBeAg-negative mothers. Extensive health education, routine screening, and immunization against HBV during pregnancy are highly warranted to minimize the possibility of perinatal transmission.

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“…As these outcomes were rare, the odds ratios estimated crude (RR) and adjusted relative risks (aRR). Potential confounders for adjusted models were selected based on review of the literature [ 6 , 7 , 10 , 23 ]. We considered maternal age, race, country of origin, marital status, education level, parity, gravidity prepregnancy BMI, and tobacco use as potential confounders for all outcomes.…”

Section: Methodsmentioning

confidence: 99%

Maternal Hepatitis B Infection and Pregnancy Outcomes in the United States: A Population-Based Cohort Study

Bajema

Karita

Tenforde

et al. 2018

Open Forum Infectious Diseases

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BackgroundHepatitis B virus (HBV) infection in pregnancy has been associated with risk of adverse maternal and infant outcomes in highly endemic settings, but this association is not well characterized in the United States.MethodsWe conducted a retrospective population-based cohort study in Washington State using linked birth certificate and hospital discharge records from 1992–2014. Among pregnant women with hepatitis B (n = 4391) and a hepatitis B–negative group (n = 22 410), we compared the risk of gestational diabetes, pre-eclampsia, eclampsia, placenta previa, preterm delivery, low birthweight, small for gestational age, and large for gestational age using multivariate logistic regression.ResultsHepatitis B–infected pregnant women were more likely to be Asian (61% vs 8%, P < .001), foreign-born (76% vs 23%, P < .001), and older in age (77% vs 64% ≥26 years, P < .001). They were less commonly overweight or obese (33% vs 50%, P < .001). There was a lower risk of small for gestational age infants among HBV-infected women (adjusted RR [aRR], 0.79; 95% confidence interval [CI], 0.67–0.93). The risk of other adverse outcomes was not significantly different between hepatitis B–infected and –negative women (gestational diabetes: aRR, 1.11; 95% CI, 0.92–1.34; pre-eclampsia: aRR, 1.06; 95% CI, 0.82–1.35; eclampsia: aRR, 2.31; 95% CI, 0.90–5.91; placenta previa: aRR, 1.16; 95% CI, 0.35–3.84; preterm delivery: aRR, 1.15; 95% CI, 0.98–1.34; low birth weight: aRR, 1.08; 95% CI, 0.90–1.29; large for gestational age: aRR, 1.01; 95% CI, 0.82–1.24).ConclusionsIn a low-burden setting in the United States, hepatitis B infection was not associated with adverse pregnancy outcomes.

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The impact of intrahepatic cholestasis of pregnancy with hepatitis B virus infection on perinatal outcomes

Cited by 14 publications

References 20 publications

Maternal HBsAg carriers and pregnancy outcomes: a retrospective cohort analysis of 85,190 pregnancies

Maternal HBsAg carriers and pregnancy outcomes: a retrospective cohort analysis of 85,190 pregnancies

Different interventional criteria for chronic hepatitis B pregnant women with HBeAg(+) or HBeAg(-)

Maternal Hepatitis B Infection and Pregnancy Outcomes in the United States: A Population-Based Cohort Study

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