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HBsAg positivity during pregnancy and adverse maternal outcomes: a retrospective cohort analysis
Author(s) -
Tan J.,
Liu X.,
Mao X.,
Yu J.,
Chen M.,
Li Y.,
Sun X.
Publication year - 2016
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12545
Subject(s) - medicine , obstetrics , gestational diabetes , pregnancy , caesarean section , retrospective cohort study , hbsag , placenta previa , cholestasis of pregnancy , population , cohort study , hepatitis b virus , gestation , fetus , placenta , immunology , virus , environmental health , biology , genetics
Summary Hepatitis B virus infection characterized by HB sAg positivity during pregnancy is a well‐recognized issue in developing countries, but the association between HB sAg positivity and adverse maternal outcomes remains uncertain. To examine the association between HB sAg positivity during pregnancy and adverse maternal outcomes, a retrospective cohort study was conducted in Sichuan province, China. Deliveries were recorded from six hospitals between 1 January 2009 and 31 December 2010. Pre‐eclampsia, gestational diabetes mellitus ( GDM ), postpartum haemorrhage ( PPH ), intrahepatic cholestasis, Caesarean section and placenta previa were prespecified adverse maternal outcomes. We used two multivariate logistic regression models to assess the association between HB sAg positivity and adverse maternal outcomes. In total, 948 (4.2%) pregnant women were HB sAg positive from 22 374 deliveries. Pregnant women with positive HB sAg had higher risk of GDM ( aOR 1.41, 95% CI 1.15–1.74), PPH (1.44, 1.13–1.83), intrahepatic cholestasis (1.74, 1.40–2.16) and Caesarean section (1.24, 1.06–1.45). No statistical associations were found between HB sAg positivity and pre‐eclampsia (1.36, 0.94–1.97), and placenta previa (1.21, 0.87–1.67). HB sAg positivity during pregnancy was associated with higher risk of multiple adverse maternal outcomes. Although the causality has yet to be established, efforts may be warranted in routine care, particularly in those with high risk for adverse maternal outcomes, given the volume population infected with HB sAg. Future studies are needed to establish causality and examine the impact of HB eAg on the adverse outcomes.