Hepatitis B infection and intrahepatic cholestasis of pregnancy

Jiang, Ruowei; Wang, Ting; Yao, Yingsha; Zhou, Feifei; Huang, Xiufeng

doi:10.1097/md.0000000000021416

Cited by 24 publications

(18 citation statements)

References 51 publications

(50 reference statements)

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“…In addition, we also found that the two groups had statistically significant differences in intrahepatic cholestasis during pregnancy ( P < 0.001). In the meta-analysis conducted by Jiang et al [ 25 ], we found that HBV infection was a high-risk factor for intrahepatic cholestasis during pregnancy. Cai et al [ 26 ] also reached a similar conclusion.…”

Section: Discussionmentioning

confidence: 94%

Pregnancy complicated with hepatitis B virus infection and preterm birth: a retrospective cohort study

Zheng

Zhang

Chen

et al. 2021

BMC Pregnancy Childbirth

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Background We aimed to investigate whether maternal chronic hepatitis B virus (HBV) infection affects preterm birth (PTB) in pregnant women. Methods We retrospectively analyzed HBV-infected and non-infected pregnant women attending antenatal care at Fujian Maternity and Child Health Hospital, Fuzhou, China between January 1, 2016 to December 31, 2018. Participants were divided into HBV infection (n = 1302) and control (n = 12,813) groups. We compared baseline data, pregnancy and perinatal complications, and preterm delivery outcomes between groups. Performed multiple logistics regression analysis to adjust for confounding factors. Finally, we compared early PTB outcome between different HBV DNA level groups. Results The incidence of preterm birth (gestation less than 37 weeks) was similar between the groups, early preterm birth (gestation less than 34 weeks) were significantly more among the HBV infection group than among the controls (1.6% VS. 0.8%; P = 0.003). After adjusting for confounding factors through logistics regression, HBV infection was found to be an independent early PTB risk factor gestation (adjusted odds ratio 1.770; 95% confidence interval [1.046–2.997]). The incidence of early PTB in < 500 group, 500 ~ 2.0 × 10e5 group and > 2.0 × 10e5 group was not statistically significant (P = 0.417). Conclusion HBV infection is an independent risk factor for early PTB, and the risk did not seem to be influenced by the levels of HBV DNA. Comprehensive programs focusing on pregnant women with HBV infection would reduce the incidence of adverse outcomes.

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Section: Discussionmentioning

confidence: 94%

Pregnancy complicated with hepatitis B virus infection and preterm birth: a retrospective cohort study

Zheng

Zhang

Chen

et al. 2021

BMC Pregnancy Childbirth

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“…Zhang et al [61] conducted a large retrospective cohort study (n = 85,190) and showed that pregnant HBV carriers were more likely to present intrahepatic cholestasis of pregnancy (ICP) (OR 3.4, 95% CI 2.80 to 4.13). Additionally, Jiang et al [62] performed a systematic review and meta-analysis on the association between HBV infection and intrahepatic cholestasis (ICP) and demonstrated a higher risk of ICP with OR of 1.68 (95% CI 1.43-1.97; I2 = 0%) among HBV-positive mothers. Moreover, the mothers with ICP also had increased risk of HBV infection.…”

Section: Pregnancy Outcomesmentioning

confidence: 99%

Hepatitis B Virus Infection in Pregnancy: Immunological Response, Natural Course and Pregnancy Outcomes

Sirilert

Tongsong

2021

JCM

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This review aimed to provide an update on the impact of pregnancy on the natural course of hepatitis B virus (HBV) infection and also on the impact of HBV infection on adverse pregnancy outcomes, including mother-to-child transmission (MTCT). For the literature review, original research articles, review articles, and guidelines were narratively reviewed and comprehensively validated. The databases of PubMed, EMBASE, and CINAHL were carefully searched for articles in English on topics related to HBV infection, pregnancy, and vertical transmission from 1960 to May 2021. Immunological changes during pregnancy such as suppression of Th1 response and induction of Th2 immunity lead to an impaired immune reaction to HBV and stimulate viral activity along with the reduction of CD8 T cells to escape immune detection. The impact of pregnancy on the natural course of chronic HBV infection seems to be minimal, while pregnancy can increase morbidity and mortality in the case of advanced HBV hepatitis or cirrhosis. Importantly, hepatitis flare or alanine aminotransferase (ALT) flare can occur during pregnancy and is more common during the postpartum period due to the interaction between HBV and the immune response. Interestingly, the impact of HBV infection on adverse pregnancy outcomes is more serious than ever thought. Updated evidence indicates that pregnancies with chronic HBV infection increase the risk of preterm birth and gestational diabetes, especially in cases of positive hepatitis e antigen (HBeAg).

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“…In addition, we also found that the two groups had statistically signi cant differences in intrahepatic cholestasis during pregnancy (P < 0.001). In the metaanalysis conducted by Jiang et al [24] , we found that HBV infection was a high-risk factor for intrahepatic cholestasis during pregnancy. Cai et al [25] also reached a similar conclusion.…”

Section: Discussionmentioning

confidence: 88%

Pregnancy Complicated With Hepatitis B Virus Infection and Preterm Birth: A Retrospective Cohort Study

Zheng¹,

Zhang²,

Chen³

et al. 2021

Preprint

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Background: We aimed to investigate whether maternal chronic hepatitis B virus (HBV) infection affects preterm birth（PTB) in pregnant women. Methods: We retrospectively analyzed HBV-infected and non-infected pregnant women attending antenatal care at Fujian Provincial Maternity and Child Health Hospital, Fuzhou, China between January 1, 2016 to December 31, 2018. Participants were divided into HBV infection (n = 1302) and control (n = 12813) groups. We compared baseline data, pregnancy and perinatal complications, and preterm delivery outcomes between groups and performed subgroup comparisons and multiple logistics regression analysis to adjust for confounding factors. Results: The incidence of PTBs before 37 weeks was similar between the groups. PTBs before 34 weeks were significantly more among the HBV infection group than among the controls (1.6% VS. 0.8% ; P = 0.003) After adjusting for confounding factors through logistics regression, HBV infection was found to be an independent PTB risk factor before 34 weeks gestation (adjusted odds ratio 1.796; 95% confidence interval[1.071, 3.012]). According to the subgroup analysis based on whether hepatitis B e-antigen (HBeAg) was positive and whether alanine aminotransferase (ALT) levels were normal during the second trimester, PTB was more frequent in HBeAg negative HBV infection before 34 weeks than among controls(1.8% VS. 0.8%). The PTB rate for pregnant women with normal ALT and HBV infection before 34 weeks was higher than that of the controls (1.6% VS. 0.8%) Conclusion HBV infection is an independent risk factor for PTB before 34 weeks. Comprehensive programs focusing on pregnant women with HBV infection would reduce the incidence of adverse outcomes.

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Hepatitis B infection and intrahepatic cholestasis of pregnancy

Cited by 24 publications

References 51 publications

Pregnancy complicated with hepatitis B virus infection and preterm birth: a retrospective cohort study

Pregnancy complicated with hepatitis B virus infection and preterm birth: a retrospective cohort study

Hepatitis B Virus Infection in Pregnancy: Immunological Response, Natural Course and Pregnancy Outcomes

Pregnancy Complicated With Hepatitis B Virus Infection and Preterm Birth: A Retrospective Cohort Study

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