Maternal hepatitis B surface antigen carrier status and its impact on neonatal outcomes: a cohort study of 21 947 singleton newborns in China

Abstract

Objective: To explore the impact of maternal hepatitis B surface antigen (HBsAg) carrier status on neonatal outcomes.

Methods: A retrospective cohort study was conducted using data from medical records database of six hospitals in China. Information on maternal characteristics and selected neonatal outcomes was retrieved for all women who delivered singleton infants between 1 January 2009 and 31 December 2010.

Results: A total of 21 947 singleton newborns and their mothers were included. The prevalence of maternal HBsAg positivity was 4.2% (95% confidence interval (CI) 3.9–4.5%). Compared with infants born to HBsAg-negative women, infants born to HBsAg-positive mothers were more than twice more likely to have a malformation before (adjusted odds ratio (aOR) 2.23, 95% CI 1.15–4.30) and at birth (aOR 2.66, 95% CI 1.38–5.14), but were less likely to be macrosomia (aOR 0.67, 95% CI 0.47–0.96). No statistically significant association was found between maternal HBsAg positivity and preterm birth (aOR 1.20, 95% CI 0.95–1.51), low birth weight (aOR 1.24, 95% CI 0.91–1.69), and Apgar scores at 1 min (aOR 0.88, 95% CI 0.49–1.57) and 5 min (aOR 1.84, 95% CI 0.89–3.81).

Conclusion: Maternal HBsAg positivity may be associated with a higher risk of congenital malformation.

Keywords:

• HBsAg carrier status
• neonatal outcome
• congenital malformation
• cohort study

Acknowledgments

We thank all of the following researchers and clinical staffs from the Chinese Evidence-based Medicine Center, the West China Women’s and Children’s Hospital, Zigong Maternal and Child Care Service Centre, Panzihua Maternal and Child Care Service Centre, Pengzhou Maternal and Child Care Service Centre, Chengdu Fifth People’s Hospital, and Suining Central Hospital for project coordination.

This study was approved by Medical Ethics Committee of West China Second Hospital, Sichuan University (Approval number: 2014–020 and date of approval: September 18th 2014).

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article. This work was supported by “Science-technology Support Plan” of Science and Technology Department of Sichuan Province (grant number 2013SZ0004), Young Investigator Award, Sichuan University (grant number 2013SCU04A37), and “Thousand Youth Talents Plan” of China (grant number D1024002).