产妇乙肝病毒携带状态及妊娠结局：一项前瞻性队列研究。

StephenW

BMC Pregnancy Childbirth. 2016 Apr 26;16(1):87. doi: 10.1186/s12884-016-0884-1.
Maternal hepatitis B virus carrier status and pregnancy outcomes: a prospective cohort study.Cui AM1, Cheng XY1, Shao JG2, Li HB3, Wang XL4, Shen Y4, Mao LJ1, Zhang S4, Liu HY1, Zhang L5, Qin G6,7.
Author information

• 1Department of Obstetrics, The Obstetrics & Gynecology Hospital of Nantong University, Nantong, Jiangsu, China.
• 2Center for Liver Diseases, Nantong Third People's Hospital, Nantong University, Nantong, Jiangsu, China.
• 3Department of Clinical Laboratory, The Obstetrics & Gynecology Hospital of Nantong University, Nantong, Jiangsu, China.
• 4Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, 9 Se-Yuan Road, Nantong, Jiangsu, 226000, China.
• 5Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VIC, Australia.
• 6Center for Liver Diseases, Nantong Third People's Hospital, Nantong University, Nantong, Jiangsu, China. [email protected].
• 7Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, 9 Se-Yuan Road, Nantong, Jiangsu, 226000, China. [email protected].
  

AbstractBACKGROUND: Infection with hepatitis B virus (HBV) in pregnant women may be a threat for both mothers and fetuses. This study was performed to explore the impact of maternal HBV carrier status on pregnancy outcomes.
METHODS: We conducted a prospective cohort study at the Obstetrics & Gynecology Hospital of Nantong University between January 1, 2012 and September 30, 2015. A consecutive sample of 21,004 pregnant women, 513 asymptomatic HBV carriers and 20,491 non-HBV controls, was included in this study. The main outcomes of interest were selected pregnancy outcomes including miscarriage, stillbirth, preterm birth (PTB), gestational diabetes (GDM), intrahepatic cholestasis of pregnancy (ICP), preterm premature rupture of the membrane (PPROM), low birth weight (LBW), small for gestational age (SGA) and Apgar scores. The incidence of adverse pregnancy outcomes between asymptomatic HBV carriers and non-HBV controls were compared using the chi-square test and logistic regression. P values were two sided, and P <0.05 was considered to indicate statistical significance.
RESULTS: The incidences of stillbirth, PTB, GDM, ICP, PPROM, LBW, and SGA were similar between the HBV carrier and non-HBV groups. The proportion of miscarriage was significantly higher among the HBV carriers than the controls (9.36 % vs 5.70 %; P <0.001). After using multivariate modelling to adjust for possible socio-demographical variables and obstetric complications, women with HBV carrier status were still more likely to have miscarriage (adjusted OR 1.71, 95 % CI 1.23-2.38). In addition, the incidences of other maternal and neonatal outcomes were similar between the two groups.
CONCLUSION: Maternal HBV carrier status may be an independent risk factor for miscarriage and careful surveillance is warranted.


KEYWORDS: Hepatitis B virus infection; Miscarriage; Pregnancy

StephenW

BMC妊娠分娩。 2016年04月26日; 16（1）：87。 DOI：10.1186 / s12884-016-0884-1。
产妇乙肝病毒携带状态及妊娠结局：一项前瞻性队列研究。
崔AM1，郑XY1，邵JG2，李HB3，王XL4，沉Y4，毛LJ1，张S4，刘HY1，张L5，秦G6,7。
作者信息

    妇产科教研室，南通大学，南通市，江苏省，中国的妇产科医院。
    2Center肝病，南通市第三人民医院，南通大学，南通市，江苏省，中国。
    临床实验室3Department，南通大学，南通市，江苏省，中国的妇产科医院。
    流行病学与卫生统计学，公共卫生，南通大学，9硒元路，江苏南通，226000，中国学院4Department。
    医学，护理和健康科学，莫纳什大学，墨尔本，澳大利亚5Faculty。
    6Center肝病，南通市第三人民医院，南通大学，南通市，江苏省，中国。 [email protected]。
    流行病学与卫生统计学，公共卫生，南通大学，9硒元路，江苏南通，226000，中国学院7Department。 [email protected]。

抽象
背景：

感染的孕妇乙型肝炎病毒（HBV）可用于母亲和胎儿的一种威胁。进行这项研究探讨孕妇乙肝病毒携带者身份对妊娠结局的影响。
方法：

我们进行了2015年2012年1月1日和9月30日，21004孕妇，513无症状乙肝病毒携带者和20491非HBV控制的连续采样之间的南通大学妇产科医院一项前瞻性队列研究，被列入本次研究。感兴趣的主要成果是选择妊娠结局，包括流产，死胎，早产（PTB），妊娠糖尿病（GDM），妊娠肝内胆汁淤积症（ICP），膜（PPROM）的早产胎膜早破，低出生体重（LBW） ，小于胎龄儿（SGA）和Apgar评分。无症状乙肝病毒携带者和非乙肝病毒对照组之间不良妊娠结局的发生率用卡方检验和logistic回归进行了比较。 P值分别为双面和P <0.05被认为具有统计学意义。
结果：

死胎的发生率，PTB，GDM，ICP，未足月胎膜早破，低出生体重，和SGA的是乙肝病毒载体和非乙肝组之间的相似。流产的比例是乙肝病毒携带者比对照组中高显著（9.36％和5.70％; P <0.001）。使用多变量模型调整为可能的社会人口变量和产科并发症后，女性乙肝病毒携带者仍更​​可能有流产（调整OR 1.71，95％CI 1.23-2.38）。此外，其他孕产妇和新生儿结局的发生率两组相似。
结论：

流产和认真监督是必要的产妇乙肝病毒携带者身份可能是一个独立的危险因素。
关键词：

乙肝病毒感染;流产;怀孕