母亲乙型肝炎病毒感染与妊娠结局：中国武汉医院病例对照

StephenW

J Clin Gastroenterol. 2017 Jul 18. doi: 10.1097/MCG.0000000000000842. [Epub ahead of print]
Maternal Hepatitis B Virus Infection and Pregnancy Outcomes: A Hospital-based Case-control Study in Wuhan, China.Wan Z1, Zhou A, Zhu H, Lin X, Hu D, Peng S, Zhang B, Du Y.
Author information
1*Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology †Wuhan Women and Children Medical and Healthcare Center, Wuhan, Hubei ‡Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.

AbstractGOALS: To examine the impact of maternal hepatitis B virus infection on pregnancy outcomes.
BACKGROUND: Studies regarding hepatitis B virus infection and pregnancy outcomes are limited with inconsistent results, and none of them have evaluated the effect of maternal viral load in pregnancy on pregnancy outcomes.
STUDY: A hospital-based case-control study was conducted. In total, 1728 hepatitis B surface antigen (HBsAg)-positive women who delivered consecutively at Wuhan Women and Children Medical and Healthcare Center, Wuhan, China, from June 2008 to May 2015, were compared with 1497 HBsAg-negative women giving birth in the same hospital during the same period who were randomly identified and selected from the computerized medical record database in parallel. Univariate and multivariate logistic regression models were constructed.
RESULTS: After adjusting for confounding variables, maternal HBsAg carriage was associated with increased risk of pregnancy-induced hypertension [adjusted odds ratio (aOR)=2.20; 95% confidence interval (CI), 1.30-3.73], fetal distress (aOR=1.40; 95% CI, 1.09-1.78), cesarean delivery (aOR=1.70; 95% CI, 1.45-1.99), and macrosomia (aOR=1.68; 95% CI, 1.19-2.37). Moreover, maternal viral load in the second trimester was significantly associated with risk of preterm birth (aOR for each log10 copy/mL increase, 1.18; 95% CI, 1.01-1.39) among HBsAg carriers after adjustment for maternal age, employment, parity, history of abortion, and prenatal body mass index.
CONCLUSIONS: Maternal HBsAg carriage was associated with several adverse pregnancy outcomes. Furthermore, hepatitis B viral activity in pregnancy might have certain effects on pregnancy outcomes. Careful surveillance of maternal HBsAg status as well as viral activity in the second trimester among HBsAg carriers is warranted.


PMID:28723858DOI:10.1097/MCG.0000000000000842

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StephenW

J Clin Gastroenterol。 2017 Jul 18. doi：10.1097 / MCG.0000000000000842。 [提前印刷]
母亲乙型肝炎病毒感染与妊娠结局：中国武汉医院病例对照研究。
万Z1，周A，朱浩，林旭，胡德鹏，彭S，张伯杜
作者信息

1
    *华中科技大学同济医学院公共卫生学院妇幼保健系†湖北省武汉市武汉市妇幼保健中心‡公共卫生学院流行病与卫生统计系医科大学，北京，中国。

抽象
目标：

检查母亲乙型肝炎病毒感染对妊娠结局的影响。
背景：

关于乙型肝炎病毒感染和妊娠结局的研究受到限制，结果不一致，没有人评估了怀孕期间母亲病毒载量对妊娠结局的影响。
研究：

进行了以医院为基础的病例对照研究。 2008年6月至2015年5月，中国武汉武汉妇幼保健中心连续交付的1728例乙型肝炎表面抗原（HBsAg）阳性妇女与1497例HBsAg阴性妇女相比，同一时期同一家医院同时从电脑病历数据库中随机识别并选出。构建单变量和多变量逻辑回归模型。
结果：

调整混淆因素后，母亲HBsAg运动与妊娠高血压风险增加相关[调整后比值（aOR）= 2.20; 95％可信区间（CI），1.30-3.73]，胎儿窘迫（aOR = 1.40; 95％CI，1.09-1.78），剖宫产分娩（aOR = 1.70; 95％CI，1.45-1.99）和巨大儿（aOR = 1.68; 95％CI，1.19-2.37）。此外，妊娠中期母亲的病毒载量与孕产妇年龄，就业，平等率调整后HBsAg携带者的早产风险（aOR为每个log10拷贝/ mL增加，1.18; 95％CI，1.01-1.39）显着相关，堕胎史，产前体重指数。
结论：

母亲HBsAg运动与几种不良妊娠结局相关。此外，怀孕期间的乙型肝炎病毒活动可能对妊娠结局有一定的影响。监测HBsAg携带者母体HBsAg状态以及妊娠晚期的病毒活动是有必要的。

结论：
    28723858
DOI：
    10.1097 / MCG.0000000000000842