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Mother‐to‐child transmission of hepatitis B virus after amniocentesis: A retrospective matched cohort study
Author(s) -
Han Zhenyan,
Zhang Yuan,
Bai Xiaoyi,
Yin Yuzhu,
Xu Chengfang,
Hou Hongying
Publication year - 2019
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.5452
Subject(s) - amniocentesis , hbsag , medicine , hbeag , hepatitis b virus , obstetrics , hepatitis b , transmission (telecommunications) , pregnancy , prenatal diagnosis , immunology , virus , fetus , biology , genetics , electrical engineering , engineering
Objective The objective of this study is to determine whether amniocentesis increases the risk of mother‐to‐child transmission (MTCT) of hepatitis B virus (HBV) and evaluate risk factors for MTCT. Methods One hundred forty‐three hepatitis B surface antigen (HBsAg)–positive women with amniocentesis were enrolled into the amniocentesis group. Six hundred five nonamniocentesis cases were matched with amniocentesis cases based on maternal viral loads, antiviral therapy regimens, and delivery dates. MTCT of HBV was defined as HBsAg and/or DNA positivity in infants from birth to age 7 to 12 months. Results Mother‐to‐child transmission rate was significantly higher in HBsAg‐positive women with amniocentesis than in those without amniocentesis (2.80% vs 0.50%; relative risk [RR], 5.64; 95% CI, 1.28‐24.93). In the amniocentesis group, maternal HBV DNA more than or equal to 7.0 log 10 IU/mL and hepatitis B e‐antigen (HBeAg) positivity were associated with higher MTCT rates than maternal HBV DNA less than 7.0 log 10 IU/mL (10.81% vs 0%, p = .004) and HBeAg negativity (8.16% vs 0%, p = .013), and antiviral therapy reduced MTCT rate from 14.3% to 0% ( p = .554) when maternal HBV DNA was more than or equal to 7.0 log 10 IU/mL. Conclusions Amniocentesis increases the risk of MTCT in women with hepatitis B, and maternal HBV DNA more than or equal to 7.0 log 10 IU/mL and HBeAg positivity are risk factors for MTCT. Antiviral therapy may be effective to prevent MTCT after amniocentesis in highly viremic mothers.