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1846
Long-Term Follow-up of Growth Parameters of
Children with Maternal Tenofovir Treatment
during Pregnancy
Huey-Ling Chen1, Wan-Hsin Wen2, Jia-Feng Wu3, Yen-Hsuan
Ni1, Chien-Nan Lee3, Lu Lu Zhao4, Ming-Wei Lai5, Shu-Chi
Mu6, Hong-Yuan Hsu1 and Mei-Hwei Chang7, (1)National
Taiwan University, (2)Cardinal Tien Hospital, (3)National
Taiwan University Hospital, (4)Tzu Chi Hospital, (5)Division of
Pediatric Gastroenterology, Department of Pediatrics, Chang
Gung Memorial Hospital; Liver Research Center, Chang
Gung Memorial Hospital; Chang Gung University College
of Medicine, (6)Shin Kong Hospital, (7)College of Medicine,
National Taiwan University, Taipei, Taiwan
Background: Tenofovir disoproxil fumarate (TDF) treatment
in late pregnancy to prevent mother-to-infant transmission of
hepatitis B virus (HBV) has been increasingly utilized. However,
data regarding children’s long-term growth beyond 1 year are
lacking. This study reports the long-term follow-up of growth
parameters of the children born to HBV-infected mothers with
and without TDF treatment from 30-32 gestational weeks
until 1 month postpartum in a prospective, multicenter trial.
Methods: One hundred and eighteen children, including 65 in
the TDF group and 53 in the control group, were included. A
total of 191 records of visit were analyzed. Two children (2/65,
3.1%) in the TDF group and five children (5/53, 9.4%) in the
control group were chronically infected with HBV. Children’s
growth was evaluated by the age and sex-adjusted z-scores
of weight for age and height for age, based on the WHO Child
Growth Standards. Markers related to bone metabolism,
including serum calcium, phosphorus, bone specific alkaline
phosphatase (BSAP), and 25(OH)-vitamin D (calcidiol)
were measured. Bone mineral density was evaluated by
dual-energy x-ray absorptiometery (DEXA) scans of the left
hip. Results: Children’s age at visit ranged from 1.5 to 6.6
(median, 3.9) years, and was comparable between the TDF
and control group (3.66 ± 1.15 vs. 3.97 ± 1.23 years, P =
0.075). No differences in the z-scores for weight-for-age (0.29
± 0.91 vs. 0.28 ± 1.01, P = 0.937) and z-scores for height-forage
(0.19 ± 1.08 vs. 0.27 ± 1.01, P = 0.598) were detected
between the TDF group and control group. Children in the
TDF group had similar serum calcium (2.66 ± 0.47 vs. 2.57
± 0.17 mmol/L, P = 0.077), serum phosphorus (5.24 ± 0.67
vs. 5.19 ± 0.56 mg/dL, P = 0.550), serum BSAP (63.29 ±
20.73 vs. 61.66 ± 20.25 mg/L, P = 0.590) and serum calcidiol
(33.60 ± 9.24 vs. 32.28 ± 8.75 ng/mL, P = 0.321) levels with
those in the control group. Sixty-one children underwent
DEXA scans of the lumbar spines and the left hip. The bone
mineral densities of the lumbar spines (L1- L4) (0.54 ± 0.07
vs. 0.55 ± 0.08, P = 0.857), and the left hip (0.53 ± 0.07 vs.
0.54 ± 0.07, P = 0.466) were similar between the TDF and
control group after adjustment for age, sex and HBV status by
multiple linear regression (Figure 1). Conclusion: Maternal
TDF treatment during late pregnancy to prevent mother-to infant
transmission of HBV was safe and did not affect longterm
children’s growth and bone metabolism. |
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发表于 2018-10-27 20:39