乙肝携带者病毒载量与妊娠结局的关系

StephenW

乙肝携带者病毒载量与妊娠结局的关系
张家宏 1 , 王伟兰 2 , 苏宝琳 3 , 黄仁勋 4 , 麦水琳 5 , 许玮妮 6 , 咪咪天仁 濑户 2
隶属关系
隶属关系

    1
    香港大学玛丽医院妇产科。电子地址：[email protected]。
    2
    香港大学玛丽医院妇产科。
    3
    中国香港屯门医院妇产科。
    4
    中国香港东区尤德那打素医院妇产科。
    5
    中国香港伊利沙伯医院妇产科。
    6
    中国香港广华医院妇产科。

    PMID：35779912 DOI：10.1016/j.tjog.2021.08.006

抽象的

目的：怀孕的乙型肝炎携带者可能有较高的不良妊娠结局风险。目前关于乙型肝炎病毒 (HBV) 与各种妊娠并发症之间关系的证据相互矛盾，因为纳入了具有不同病毒活性的女性。本研究旨在评估香港怀孕乙型肝炎携带者的乙型肝炎 e 抗原 (HBeAg) 状态/HBV DNA 水平与妊娠结局之间的关系。

材料与方法：这是对 2014 年至 2016 年在香港进行的一项前瞻性多中心观察性研究的回顾性分析。招募了怀孕的 HBV 携带者。测试了 HBeAg。在妊娠 28-30 周时对 HBV DNA 水平进行量化。记录妊娠期糖尿病（GDM）、妊娠期高血压、先兆子痫、早产胎膜早破（PPROM）、早产、低出生体重（LBW）、巨大儿和分娩方式的发生率。

结果：分析了 679 例妊娠。 23.3% 的女性 HBeAg 血清学呈阳性。妊娠 28-30 周的平均病毒载量 (SD) 为 3.6 (2.5) log10IU/ml。不同病毒载量水平（≤2 log10IU/ml、2.01-6 log10IU/ ml 和 >6 log10IU/ml）。与血清阴性女性相比，阳性母亲 HBeAg 状态与妊娠并发症无关。

结论：妊娠期间血清阳性 HBeAg 状态或更高水平的 HBV DNA 不会对妊娠结局产生显着的负面影响。

关键词：并发症；妊娠糖尿病;乙型肝炎病毒;先兆子痫;怀孕。

版权所有 © 2022。Elsevier B.V. 出版

StephenW

Relationship between viral load and pregnancy outcomes among hepatitis B carriers
Ka Wang Cheung  1 , Weilan Wang  2 , Po Lam So  3 , Daniel Wong  4 , Annisa Shui Lam Mak  5 , Winnie Hui  6 , Mimi Tin Yan Seto  2
Affiliations
Affiliations

    1
    Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China. Electronic address: [email protected].
    2
    Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
    3
    Department of Obstetrics & Gynaecology, Tuen Mun Hospital, Hong Kong, China.
    4
    Department of Obstetrics & Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
    5
    Department of Obstetrics & Gynaecology, Queen Elizabeth Hospital, Hong Kong, China.
    6
    Department of Obstetrics & Gynaecology, Kwong Wah Hospital, Hong Kong, China.

    PMID: 35779912 DOI: 10.1016/j.tjog.2021.08.006

Abstract

Objective: Pregnant hepatitis B carriers may have a higher risk of adverse pregnancy outcomes. Current evidences are conflicting regarding the relationship between hepatitis B virus (HBV) and various pregnancy complications, owing to the inclusion of women with different viral activity. This study is to evaluate the relationship between hepatitis B e antigen (HBeAg) status/HBV DNA level and pregnancy outcomes among pregnant hepatitis B carriers in Hong Kong.

Materials and methods: This was a retrospective analysis of a prospective multicenter observational study carried out in Hong Kong between 2014 and 2016. Pregnant HBV carriers were recruited. HBeAg was tested. HBV DNA level was quantified at 28-30 weeks of gestation. The rates of gestational diabetes mellitus (GDM), gestational hypertension, pre-eclampsia, preterm prelabour rupture of membranes (PPROM), preterm birth, low birth weight (LBW), macrosomia and mode of delivery were recorded.

Results: 679 pregnancies were analyzed. 23.3% of women were seropositive for HBeAg. The mean viral load (SD) at 28-30 weeks of gestation was 3.6 (2.5) log10IU/ml. No statistically significant differences were found in the rates of GDM, gestational hypertension, pre-eclampsia, PPROM, preterm birth, LBW, macrosomia and mode of delivery among women with different viral load levels (≤2 log10IU/ml, 2.01-6 log10IU/ml and >6 log10IU/ml). Positive maternal HBeAg status was not associated with pregnancy complications compared to seronegative women.

Conclusion: Seropositive HBeAg status or a higher level of HBV DNA during pregnancy did not pose a significant negative impact to the pregnancy outcomes.

Keywords: Complications; Gestational diabetes; Hepatitis B virus; Pre-eclampsia; Pregnancy.

Copyright © 2022. Published by Elsevier B.V.

StephenW

https://doi.org/10.1016/j.tjog.2021.08.006