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

Abstract

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.

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

“…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)].…”

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

“…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.…”

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

“…Following publication of the original article [ 1 ], the authors reported an error in Tables 1 , 2 and 3 headers. The correct tables are given below.…”