Association between hepatitis B virus replication during pregnancy and perinatal outcomes: a retrospective cohort study

Abstract

Background

The effect of hepatitis B virus (HBV) replication during pregnancy on the outcomes of pregnancies remains to be elucidated.

Objectives

This study aimed to investigate the association between HBV replication and adverse maternal and infant outcomes.

Methods

We retrospectively analysed the clinical data of 836 pregnant inpatients with hepatitis B surface antigen positivity who delivered at two provincial tertiary grade A hospitals in the Fujian province between June 2016 and October 2020.

Results

The incidence of intrahepatic cholestasis of pregnancy, hypertensive syndrome complicating pregnancy, gestational diabetes mellitus, preterm birth, macrosomia, growth restriction, and vaginal infections did not differ in the HBV replication and non-replication groups (p > 0.05); however, the rates of caesarean section (p = 0.017; OR, 1.423; 95% CI, 1.065–1.902) and neonatal jaundice (p < 0.001; OR, 2.361; 95% CI, 1.498–3.721) were higher in the replication group than that in the non-replication group. After using propensity score analysis to adjust for alanine transaminase and aspartate aminotransferase levels in both groups, the replication group was still found to have an increased risk for caesarean section (p < 0.001; OR, 2.367; 95% CI, 1.668–3.359) and their infants had higher rates of neonatal jaundice (p < 0.001; OR, 12.605; 95% CI, 4.456–35.656).

Conclusions

Our findings contribute to a better understanding of the association between maternal HBV replication status and perinatal outcomes. Pregnant women with HBV replication face an increased risk of caesarean section, and their infants appear to have a higher risk for neonatal jaundice.

Keywords:

• Hepatitis B virus
• neonatal jaundice
• vaginal infection
• caesarean section
• perinatal outcomes

Acknowledgements

We thank all participants and staff in this study for their work in recruiting and following up with patients.

Author contributions

PY J, YZ H, and KY M performed the data recording and telephone follow-ups. PY J and YX L performed the statistical analyses. PY J and LD drafted the manuscript. NL and FL C participated in the study design and coordination and helped to refine the manuscript. All authors have read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets generated and analysed during the current study are not publicly available and cannot be uploaded to any website due to the risk of compromising the individual privacy of participants. However, the data used to reach the study conclusions are available from the corresponding author upon reasonable request. And we uploaded it to a preprint server on Research Square (https://www.researchsquare.com/article/rs-1117183/v1).

Additional information

Funding

This work was supported by the Fujian Clinical Research Center for Digestive System Tumors and Upper Gastrointestinal Diseases, China, under Grant 2022YGPT004; The National Key Clinical Specialty Construction Projects of Fujian Province, China, under Grant 2023-1594; and the Construction Project of Fujian Province Minimally Invasive Medical Centre, China, under Grant 2021-76.