Impact of maternal infection with hepatitis B virus on pregnancy complications and neonatal outcomes for women undergoing assisted reproductive technology treatment: A population‐based study

Abstract

The aim of this study was to investigate the impact of maternal hepatitis B virus (HBV) status on pregnancy complications and neonatal outcomes for women undergoing assisted reproductive technology (ART). A total of 7,011 pregnancies achieved by ART were included from a population‐based database involving 523,111 pregnancies. Exposures of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) among pregnant women were routinely tested at the first antenatal visit for all pregnancies. We collected pregnancy complications (e.g., gestational diabetes mellitus [GDM], intrahepatic cholestasis of pregnancy [ICP]), neonatal outcomes and confounding variables from the same database. Univariate and multivariate analyses by adjusting confounders were conducted to evaluate the impact of maternal HBV infection. Prevalence of HBsAg seropositivity (HBsAg+) was 11.34% (95% CI 10.6–12.1) and that of HBsAg and HBeAg co‐seropositivity (HBsAg+HBeAg+) was 2.55% (2.1–3.0) among included population. Compared with HBsAg−group, ICP risk in the HBsAg+group was higher (4.03% vs. 1.79%; adjusted odds ratio [aOR] 2.49, 1.65−3.77). Similarly, ICP prevalence in the HBsAg+HBeAg+ group was higher than that in the HBsAg−HBeAg− group (6.47% vs. 1.61%; aOR 4.78, 2.28–9.98). No associations were found between maternal HBV infection (i.e., HBsAg+, HBsAg+HBeAg+, or HBsAg+HBeAg−) and other adverse outcomes for women undergoing ART (i.e., GDM, pre‐eclampsia, placental previa, premature separation of placenta, premature rupture of membranes, preterm birth and low birthweight) in this study. In conclusion, maternal HBV infection (HBsAg+or HBsAg+HBeAg+) probably increase ICP risk, but may not associate with other pregnancy complications or neonatal outcomes for pregnant women who underwent ART.

The effects of hepatitis B virus infection on natural and IVF pregnancy: A meta‐analysis study

“…Placenta previa was investigated in 10 studies, 14–16,19–21,23,32,33,35–37 and there was no significant association between HBV infection and placenta previa ( p = 0.43); however, HBV+ patients seemed to have higher rates of placenta previa. The obtained OR was 1.15 (0.81–1.63).…”

“…The analysis of the results of 27 articles 14–17,19–39 showed a significant association between GMD and HBV infection among pregnant women with a OR (95% CI) = 1.32 (1.17–1.48) and p < 0.01 for the overall effect, and p < 0.01 and I 2 = 87.3% for heterogeneity (Figure 2). …”

“…Thirty eligible articles concerning the effect of HBV infection on pregnancy complications were included to assess the effects of HBV on preterm birth 14–17,19–25,27,28,30–38,40–47 . The results revealed significantly higher rates of preterm birth among HBV+ women compared to HBV− women ( p < 0.01) [OR (95% CI) = 1.26 (1.14–1.40)].…”

“…Nineteen articles 14–17,19,21–28,30,32,33,35,37,39,41,46 reported the effects of HBV infection on pre‐eclampsia and the results indicated statistically significant difference between HBV+ and HBV− pregnant females regarding the rates of pre‐eclampsia occurrence ( p = 0.001). The HBV negatives seemed to have higher rates of pre‐eclampsia [OR (95% CI) = 0.83 (0.75–0.93)].…”

“…Twelve investigations 15,16,19,20,24,31,32,35–37,44–46 assessed the effects of HBV infection on PROM. However, PROM rate was higher among HBV infected women, it was insignificant ( p = 0.53) [OR (95% CI) = 1.11 (0.79–1.55)].…”