慢性乙型肝炎病毒感染与孕妇早产(分娩):一项更新的系统评价和荟萃分析。

Chronic hepatitis B virus infection and preterm labor(birth) in pregnant women-an updated systematic review and meta-analysis.

机构信息

Department of Infection, People's Hospital of Xuyi, Xuyi, Jiangsu, P.R. China.

Department of Gastroenterology, People's Hospital of Xuyi, Xuyi, Jiangsu, P.R. China.

出版信息

J Med Virol. 2018 Jan;90(1):93-100. doi: 10.1002/jmv.24927. Epub 2017 Sep 12.

Abstract

We aimed to explore whether maternal chronic hepatitis B virus (HBV) infection certainly affects preterm labor (birth) in pregnant women. Four databases were systematically searched up to May 31, 2017, without language restriction. Any study was included if it clearly defined exposure to chronic HBV infection, reported risk of preterm labor or birth in pregnant women, and reported relative risks (RRs) or odds ratios (ORs) or provided data for estimation. RRs (or ORs) with 95% confidence intervals were pooled using random-effects models. Statistical heterogeneity was assessed with Cochran's Q statistic and I statistic. Twenty-two observational studies involving 6 141 146 pregnant women (three prospective cohort studies, n = 1 116 799; 15 retrospective cohort studies, n = 5 022 513 and four case-control studies, n = 1834) were included. The risk of preterm labor was significantly intensified with chronic HBV infection compared with uninfected women, with substantial heterogeneity. Chronic HBV infection was also significantly associated with a 16% increase in the risk of preterm birth, with substantial heterogeneity. The risk of preterm birth significantly increased by 21% in HBsAg+/HBeAg+ pregnant women compared with uninfected pregnant women. Chronic HBV infection intensifies the risk of preterm labor and birth in pregnant women, but this conclusion should be interpreted with caution given the possibility of residual confounding and be confirmed by well-designed studies in the future.

摘要

我们旨在探讨母体慢性乙型肝炎病毒(HBV)感染是否会对孕妇早产(分娩)产生影响。系统检索了四个数据库,截至 2017 年 5 月 31 日,未限制语言。如果研究明确界定了慢性 HBV 感染的暴露情况、报告了孕妇早产或分娩的风险,并且报告了相对风险(RR)或比值比(OR)或提供了用于估计的数据,则纳入任何研究。使用随机效应模型汇总 RR(或 OR)和 95%置信区间。采用 Cochran's Q 统计量和 I 统计量评估统计学异质性。纳入了 22 项观察性研究,涉及 6141146 名孕妇(3 项前瞻性队列研究,n=1116799;15 项回顾性队列研究,n=5022513 和 4 项病例对照研究,n=1834)。与未感染女性相比,慢性 HBV 感染孕妇早产的风险显著增加,且存在显著异质性。慢性 HBV 感染与早产风险增加 16%显著相关,存在显著异质性。与未感染孕妇相比,HBsAg+/HBeAg+孕妇的早产风险显著增加 21%。慢性 HBV 感染会加重孕妇早产和分娩的风险,但由于存在残留混杂的可能性,因此应谨慎解释这一结论,并在未来通过精心设计的研究加以证实。

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