母亲HBsAg携带者和不良妊娠结局：基于医院的前瞻性队列分析

StephenW

J Viral Hepat. 2019 Apr 10. doi: 10.1111/jvh.13105. [Epub ahead of print]
Maternal HBsAg carriers and adverse pregnancy outcomes: a hospital-based prospective cohort analysis.
Cai QY1, Liu HY2, Han WH3, Liu LL1, Xu YY2, He YN1, Li Q3, Zhang M1, Hu AQ2, Zheng YJ1,4.
Author information

1
    Department of Epidemiology, Key Laboratory for Public Health Safety, School of Public Health; Fudan University, Shanghai, 200032, China.
2
    Department of Clinical Laboratory, Anqing Municipal Hospital, Anqing, 246003, China.
3
    Department of Obstetrics and Gynecology, Anqing Municipal Hospital, Anqing, 246003, China.
4
    Key Laboratory for Health Technology Assessment, National Commission of Health and Family planning, Fudan University, Shanghai, 200032, China.

Abstract

It is not clear whether chronic hepatitis B virus (HBV) infection during pregnancy can increase the risk of adverse pregnancy outcomes for both mothers and neonates. We conducted a hospital-based prospective cohort study on pregnant women (PW) and used an analysis strategy that was guided by directed acyclic graphs (DAGs). Maternal characteristics and major adverse pregnancy outcomes were collected both from questionnaires and hospital-based electronic medical records. Serum hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) status were determined. In total, 3329 of the 3416 pregnant women who received routine antenatal care in a hospital setting at baseline, including 346 HBsAg carriers, were available for analysis. Maternal HBsAg carrier status was associated with an increased risk of intrahepatic cholestasis pregnancy [ aOR (adjusting odds ratio) = 1.70; 95% CI (confidence interval) = 1.16-2.49], premature rupture of the membranes (aOR = 1.38; 95% CI = 1.00-1.89) and large-for-gestational-age birth aOR = 1.67; 95% CI = 1.17-2.39). The risk of intrahepatic cholestasis remained in pregnant women with either HBeAg-positive (aOR = 2.96; 95% CI =1.33-6.62) or HBeAg-negative (aOR = 1.52; 95% CI =1.00-2.32)] status; notably, only maternal HBeAg-negative status was associated with a higher risk of large for gestational age birth (aOR = 1.91; 95% CI =1.33-2.76). Our results implied that chronic HBV infection during pregnancy may increase the risk of intrahepatic cholestasis of pregnancy, premature rupture of membranes and large for gestational age pregnancies. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.
KEYWORDS:

Hepatitis B virus infection; intrahepatic cholestasis during pregnancy; large for gestational age; pregnancy outcomes; premature rupture of the membranes

PMID:
    30972911
DOI:
    10.1111/jvh.13105

StephenW

J病毒肝病。 2019年4月10日doi：10.1111 / jvh.13105。 [印刷前的电子版]
母亲HBsAg携带者和不良妊娠结局：基于医院的前瞻性队列分析。
蔡启1，刘海2，韩WH3，刘LL1，徐YY2，何YN1，李Q3，张M1，胡阿Q2，郑YJ1,4。
作者信息

1
    公共卫生学院公共卫生安全重点实验室流行病学系;复旦大学，上海200032
2
    安庆市立医院检验科，安庆246003
3
    安庆市立医院妇产科，安庆246003
4
    复旦大学国家卫生与计划生育委员会卫生技术评估重点实验室，上海200032

抽象

尚不清楚怀孕期间慢性乙型肝炎病毒（HBV）感染是否会增加母亲和新生儿不良妊娠结局的风险。我们对孕妇（PW）进行了一项基于医院的前瞻性队列研究，并使用了由有向无环图（DAG）指导的分析策略。通过问卷调查和基于医院的电子病历收集母亲特征和主要不良妊娠结局。测定血清乙型肝炎表面抗原（HBsAg）和乙型肝炎e抗原（HBeAg）状态。总共有3416名孕妇在基线医院接受过常规产前保健，其中包括346名HBsAg携带者，可供分析。母体HBsAg携带者状态与肝内胆汁淤积妊娠风险增加有关[aOR（调整比值比）= 1.70; 95％CI（置信区间）= 1.16-2.49]，胎膜早破（aOR = 1.38; 95％CI = 1.00-1.89）和大于胎龄儿出生aOR = 1.67; 95％CI = 1.17-2.39）。 HBeAg阳性（aOR = 2.96; 95％CI = 1.33-6.62）或HBeAg阴性（aOR = 1.52; 95％CI = 1.00-2.32）状态的孕妇仍存在肝内胆汁淤积的风险;值得注意的是，只有母亲HBeAg阴性状态与胎龄大的较高风险相关（aOR = 1.91; 95％CI = 1.33-2.76）。我们的研究结果表明，怀孕期间慢性HBV感染可能增加妊娠期肝内胆汁淤积，胎膜早破和妊娠期妊娠的风险。本文受版权保护。版权所有。

本文受版权保护。版权所有。
关键词：

乙型肝炎病毒感染;妊娠期肝内胆汁淤积;大于胎龄;妊娠结局;胎膜早破

结论：
    30972911
DOI：
    10.1111 / jvh.13105