Prenat Diagn. 2019 Mar 27. doi: 10.1002/pd.5452. [Epub ahead of print]
Mother-to-child transmission of hepatitis B virus after amniocentesis: a retrospective matched-cohort study.
Han Z1, Zhang Y1, Bai X1, Yin Y1, Xu C1, Hou H1.
Author information
1
Department of Obstetrics and Gynecology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, 510630, China.
Abstract
OBJECTIVE:
To determine whether amniocentesis increases the risk of mother-to-child transmission (MTCT) of hepatitis B virus (HBV) and evaluate risk factors for MTCT.
METHODS:
143 hepatitis B surface antigen (HBsAg)-positive women with amniocentesis were enrolled into the amniocentesis group. 605 non-amniocentesis cases were matched with amniocentesis cases based on maternal viral loads, antiviral therapy regimens, and delivery dates. MTCT of HBV was defined as HBsAg and/or DNA positivity in infants from birth to age 7-12 months.
RESULTS:
MTCT rate was significantly higher in HBsAg-positive women with amniocentesis than in those without amniocentesis (2.80% vs. 0.50%; RR, 5.64, 95% CI, 1.28-24.93). In the amniocentesis group, maternal HBV DNA ≥7.0 log10 IU/ml and hepatitis B e-antigen (HBeAg) positivity were associated with higher MTCT rates than maternal HBV DNA <7.0 log10 IU/ml (10.81% vs. 0%, P=0.004) and HBeAg negativity (8.16% vs. 0%, P=0.013), and antiviral therapy reduced MTCT rate from 14.3% to 0% (P=0.554) when maternal HBV DNA was ≥7.0 log10 IU/ml.
CONCLUSIONS:
Amniocentesis increases the risk of MTCT in women with hepatitis B, and maternal HBV DNA ≥7.0 log10 IU/ml and HBeAg positivity are risk factors for MTCT. Antiviral therapy may be effective to prevent MTCT after amniocentesis in highly viremic mothers.
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