Department of Medicine, Maulana Azad Medical College, New Delhi, India.
Department of Obstetrics & Gynaecology, Maulana Azad Medical College, New Delhi, India.
Liver Int. 2019 Apr;39(4):633-639. doi: 10.1111/liv.13928. Epub 2019 Feb 20.
Pregnant women infected with HEV develops adverse pregnancy outcomes like, abortions, intrauterine fetal death, still births, neonatal deaths, preterm delivery and maternal mortality.
To correlate oestrogen and its receptors ESR1α and ESR2β levels with HEV-associated feto-maternal outcomes.
MATERIAL & METHODS: A total of 142 pregnant women with HEV infection and 142 pregnant controls were included in study from Department of Obstetrics & Gynaecology and Department of Medicine, Maulana Azad Medical College (MAMC) and associated Lok Nayak Hospital (LNH), New Delhi. Three millilitre of blood sample was collected in plain for quantification of oestrogen, and its receptors ESR1α and ESR2β using commercially available third-generation ELISA kits.
The levels of oestrogen, ESR1α and ESR2β were considerably higher in HEV-infected pregnant women (20.11 ± 18.19 ng/mL, 10.58 ± 3.27 ng/mL, 10.42 ± 4.71 ng/mL respectively) than pregnant controls (11.74 ± 6.42 ng/mL, 9.11 ± 1.63 ng/mL, 9.01 ± 1.18 ng/mL respectively)(P < 0.0001). It was found that oestrogen levels were significantly higher in pregnant women infected with HEV who had preterm delivery, low birth weight babies and fetal loss (19.64 ± 17.60 ng/mL, 19.71 ± 17.63 ng/mL, 33.62 ± 23.20 ng/mL respectively) than who had full term delivery, average birth weight babies and live babies (11.71 ± 8.77 ng/mL, 11.99 ± 9.44 ng/mL, 16.58 ± 14.98 ng/mL respectively)(P < 0.05). A significant negative correlation was observed between baby birth weight and oestrogen levels in HEV-infected pregnant women.
The high level of oestrogen plays an important role in preterm delivery, low birth weight babies and fetal mortality in pregnant women with HEV infection through placental dysfunction. Moreover, oestrogen level is a significant predictor for preterm delivery and maternal mortality and ESR2β levels is a significant predictor for maternal mortality in pregnant women infected with HEV.
感染戊型肝炎病毒（HEV）的孕妇会出现不良妊娠结局，如流产、宫内胎儿死亡、死产、新生儿死亡、早产和孕产妇死亡。
探讨雌二醇及其受体 ESR1α 和 ESR2β 水平与 HEV 相关的母婴结局的相关性。
本研究共纳入 142 例感染 HEV 的孕妇和 142 例健康孕妇，分别来自印度新德里 Maulana Azad 医学学院（MAMC）及其附属医院 Lok Nayak 医院的妇产科和内科。采集 3ml 空腹血样，采用商业上可用的第三代 ELISA 试剂盒定量检测雌二醇及其受体 ESR1α 和 ESR2β。
HEV 感染孕妇的雌二醇、ESR1α 和 ESR2β 水平明显高于健康孕妇（分别为 20.11±18.19ng/ml、10.58±3.27ng/ml、10.42±4.71ng/ml）（P<0.0001）。结果发现，HEV 感染孕妇中，早产、低体重儿和胎儿丢失的孕妇雌二醇水平明显高于足月产、正常体重儿和活产孕妇（分别为 19.64±17.60ng/ml、19.71±17.63ng/ml、33.62±23.20ng/ml）（P<0.05）。HEV 感染孕妇的婴儿出生体重与雌二醇水平呈显著负相关。
HEV 感染孕妇高雌二醇水平通过胎盘功能障碍导致早产、低体重儿和胎儿死亡。此外，雌二醇水平是预测早产和孕产妇死亡的重要指标，ESR2β 水平是预测 HEV 感染孕妇孕产妇死亡的重要指标。
