The Joyce and Irving Goldman Medical School, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er-Sheva, Israel.
Liver Int. 2010 May;30(5):765-70. doi: 10.1111/j.1478-3231.2010.02218.x. Epub 2010 Mar 8.
To examine the impact of maternal hepatitis B virus (HBV) or hepatitis C virus (HCV) carrier status on pregnancy outcomes.
A population-based study was performed by comparing all pregnancies of HBsAg and/or anti-HCV seropositive women who delivered during the years 1988-2007 with all other pregnant women who delivered in the same period. Multivariable logistic regression models were constructed to control for confounders.
Seven hundred and forty-nine hepatitis seropositive pregnant women were identified out of 186 619 deliveries (0.4%). Maternal characteristics, as well as perinatal outcomes, were comparable between the HBV and HCV carriers. HBV/HCV carriers had higher rates of preterm deliveries (<37 weeks gestation; 11.5 vs. 7.9%, P<0.001), premature rupture of membranes (8.9 vs. 6.9%, P=0.026), placental abruption (1.5 vs. 0.7%, P=0.018), labour induction (33.9 vs. 28.1%, P<0.001) and Caesarean deliveries (19.0 vs. 13.2%, P<0.001). Higher rates of perinatal mortality (2.3 vs. 1.3%, P=0.016), congenital malformations (7.2 vs. 5.1%, P=0.01) and low birth weight (<2500 kg; 10.4 vs. 7.8%, P=0.009) were noted in newborns of hepatitis carriers compared with the control group. Controlling for possible confounders such as maternal age and parity by using multivariable analyses, the significant association between HBV or HCV carrier status and perinatal mortality, congenital malformations and low birth weight remained significant.
Maternal HBV or HCV carrier status is an independent risk factor for adverse perinatal outcome and careful surveillance is warranted.
探讨母体乙型肝炎病毒（HBV）或丙型肝炎病毒（HCV）携带状态对妊娠结局的影响。
通过比较 1988 年至 2007 年期间所有 HBsAg 和/或抗-HCV 血清阳性孕妇与同期所有其他孕妇的妊娠情况，进行了一项基于人群的研究。构建多变量逻辑回归模型以控制混杂因素。
在 186619 例分娩中，发现 749 例乙型肝炎血清阳性孕妇（0.4%）。HBV 和 HCV 携带者的母体特征和围产结局无差异。HBV/HCV 携带者早产（<37 周妊娠；11.5%比 7.9%，P<0.001）、胎膜早破（8.9%比 6.9%，P=0.026）、胎盘早剥（1.5%比 0.7%，P=0.018）、引产（33.9%比 28.1%，P<0.001）和剖宫产（19.0%比 13.2%，P<0.001）的发生率较高。新生儿肝炎携带者的围产儿死亡率（2.3%比 1.3%，P=0.016）、先天性畸形（7.2%比 5.1%，P=0.01）和低出生体重（<2500g；10.4%比 7.8%，P=0.009）发生率均高于对照组。多变量分析控制了母亲年龄和产次等可能的混杂因素后，HBV 或 HCV 携带状态与围产儿死亡率、先天性畸形和低出生体重之间的显著相关性仍然存在。
母体 HBV 或 HCV 携带状态是不良围产结局的独立危险因素，需要进行仔细监测。
