Prevalence of Hepatitis B Virus infection among Pregnant Women in Iran: A Systematic Review and Meta-analysis

Background: Hepatitis B infection can be transmitted both vertically and horizontally. Although the universal neonatal vaccination and catch up vaccination of teenagers along with targeted vaccination of at risk population have decreased the prevalence of HBV infection in Iran dramatically, there is still risk of vertical transmission with subsequent chronic liver disease and hepatocellular carcinoma. This study aims to estimate the prevalence of latent HBV infection among Iranian pregnant women using meta- analysis method. Data Sources: Papers written in Persian or English were identified during a comprehensive search within five national and four international main databases. Study Eligibility Criteria and Participants: Studies reported the HBV infection prevalence among Iranian pregnant women and provided enough quality scores were selected for this meta-analysis. Methods: After a systematic review of national and international databases, duplicated and irrelevant studies were excluded. Standard error of the infection prevalence was calculated based on the binomial distribution. Because of the significant heterogeneity observed among the results, random effects model was applied to combine the results of the primary studies. Moreover, sensitivity analysis and meta-regression models were used to detect the sources of this heterogeneity. Results: At final step of the systematic search, 18 papers entered into the meta-analysis investigating 24853 pregnant women. Prevalence of HBV infection among Iranian pregnant women was estimated as 1.2% (95% confidence interval: 0.9 - 1.6). Among different risk factors assessed, only familial history in four studies out of five relevant evidences was statistically significant. Conclusions: HBV infection prevalence among Iranian pregnant women is low and familial history is its major determinant.