孕产妇慢性乙型肝炎病毒感染和妊娠结局-中国昆明的单中心

StephenW

Chronic maternal hepatitis B virus infection and pregnancy outcome- a single center study in Kunming, China
Qian Sun #  1 , Terence T Lao #  2 , Mingyu Du  1 , Min Xie  1 , Yonghu Sun  1 , Bing Bai  1 , Junnan Ma  1 , Tianying Zhu  1 , Shengnan Yu  1 , Runmei Ma  3   4
Affiliations
Affiliations

    1
    Department of Obstetrics and Gynecology, the First Affiliated Hospital of Kunming Medical University, PO box 650032, No.295, Xi Chang Road, Kunming, Yunnan, China.
    2
    Department of Obstetrics and Gynecology, the Chinese University of Hong Kong, Hong Kong, China.
    3
    Department of Obstetrics and Gynecology, the First Affiliated Hospital of Kunming Medical University, PO box 650032, No.295, Xi Chang Road, Kunming, Yunnan, China. [email protected].
    4
    Department of Obstetrics and Gynecology, Kunming Angel Women and Children's Hospital, PO box 650108, No 199, Dianmian Road, Kunming, Yunnan, China. [email protected].

#
Contributed equally.

    PMID: 33691634 DOI: 10.1186/s12879-021-05946-7

Free article
Abstract

Background: Chinese population has a high prevalence of chronic hepatitis B virus (HBV) infection, the impact of which on pregnancy outcome remains controversial. A single-center retrospective cohort study was performed in Kunming, a multi-ethnic city in south-western China to examine this issue.

Methods: The singleton pregnancies delivering at ≥28 weeks gestation under our care in 2005-2017 constituted the study cohort. Maternal characteristics and pregnancy outcome were compared between mothers with and without seropositivity for hepatitis B surface antigen (HBsAg) determined at routine antenatal screening.

Results: Among the 49,479 gravidae in the cohort, the 1624 (3.3%) HBsAg seropositive gravidae had a lower incidence of nulliparity (RR 0.963, 95% CI 0.935-0.992) and having received tertiary education (RR 0.829, 95% CI 0.784-0.827). There was no significant difference in the medical history, pregnancy complications, or labor or perinatal outcome, except that HBV carriers had significantly lower incidence of labor induction (RR 0.827, 95% CI 0.714-0.958) and of small-for-gestational age (SGA) infants (RR 0.854, 95% CI 0.734-0.994). On regression analysis, maternal HBV carriage was independently associated with spontaneous labor (aRR 1.231, 95% CI 1.044-1.451) and reduced SGA infants (aRR 0.842, 95% CI 0.712-0.997).

Conclusions: Our 3.3% prevalence of maternal HBV infection was around the lower range determined in the Chinese population. The association with spontaneous labor and reduced SGA infants could have helped to promote the perpetuation of the infection through enhanced survival of the offspring infected at birth, thus explaining the high prevalence in the Chinese population.

Keywords: Chinese; Infection; Maternal hepatitis B virus; Pregnancy outcome; Prevalence.

StephenW

孕产妇慢性乙型肝炎病毒感染和妊娠结局-中国昆明的单中心研究
孙倩＃1，Terence T Lao＃2，杜明宇1，谢敏1，孙永虎1，白冰1，马俊南1，朱天英1，于圣南1，马润美3 4
隶属关系
隶属关系

    1个
    昆明医科大学附属第一医院妇产科，云南昆明西昌路295号邮政信箱650032。
    2个
    香港中文大学妇产科，中国香港。
    3
    昆明医科大学附属第一医院妇产科，云南昆明西昌路295号邮政信箱650032。 [email protected]。
    4
    昆明市安吉尔妇女儿童医院妇产科，云南省昆明市淀面路199号邮政信箱650108 [email protected]。

＃
贡献均等。

    PMID：33691634 DOI：10.1186 / s12879-021-05946-7

免费文章
抽象的

背景：中国人群的慢性乙型肝炎病毒（HBV）感染率很高，其对妊娠结局的影响尚存争议。在中国西南部多民族城市昆明进行了一项单中心回顾性队列研究，以研究此问题。

方法：2005-2017年在我们的护理下≥28周妊娠分娩的单胎妊娠构成了研究队列。在常规产前筛查中，对有或没有血清阳性的乙型肝炎表面抗原（HBsAg）的母亲之间的母亲特征和妊娠结局进行了比较。

结果：在该队列的49,479名孕妇中，有1624名（3.3％）HBsAg血清阳性孕妇的未产率较低（RR 0.963，95％CI 0.935-0.992），并且接受了大专以上学历（RR 0.829，95％CI 0.784- 0.827）。在病史，妊娠并发症或分娩或围产期结局方面无显着差异，除了HBV携带者分娩引诱的发生率显着较低（RR 0.827，95％CI 0.714-0.958）和小胎龄（ SGA）婴儿（RR 0.854，95％CI 0.734-0.994）。在回归分析中，母亲的HBV携带独立与自然分娩相关（aRR 1.231，95％CI 1.044-1.451）和SGA婴儿减少（aRR 0.842，95％CI 0.712-0.997）。

结论：在中国人群中，我们的母亲HBV感染率为3.3％，处于较低范围。与自然分娩和SGA婴儿减少有关，可以通过提高出生时被感染的后代的存活率来促进感染的延续，从而解释了中国人群的高患病率。

关键字：中文；感染;孕妇乙型肝炎病毒；怀孕结局；患病率。

StephenW

https://bmcinfectdis.biomedcentr ... 879-021-05946-7.pdf