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孕期母亲的乙型肝炎病毒和丙型肝炎病毒携带状态与子代的长期呼吸道并发症

Maternal hepatitis B virus and hepatitis C virus carrier status during pregnancy and long-term respiratory complications in the offspring.

作者信息

Govrin-Yehudain Yoad, Wainstock Tamar, Abu-Freha Naim, Sheiner Eyal

机构信息

Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Faculty of Health Sciences, The Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

出版信息

Early Hum Dev. 2020 Jan;140:104904. doi: 10.1016/j.earlhumdev.2019.104904. Epub 2019 Nov 18.

Abstract

OBJECTIVE

Maternal HBV or HCV carrier status is a cause for concern regarding both the course of pregnancy and the short-term perinatal outcomes. Our main aim was to evaluate whether offspring born to carrier mothers during pregnancy, also suffer from long-term pediatric respiratory morbidity (until 18 years of age).

METHOD OF STUDY

A population-based cohort analysis was conducted at a single tertiary medical center. The study included all singleton deliveries between the years 1991-2014, comparing incidence of respiratory-related hospitalization of offspring born to mothers who were carrier of HBV or HCV during their pregnancy to those born to nonexposed mothers. Respiratory morbidities were based on a predefined set of ICD-9 codes. A Kaplan-Meier survival curve was used to compare cumulative hospitalization incidence between the groups and a Cox regression model was used to adjust for confounding variables.

RESULTS

During the study period, 242,342 deliveries met the inclusion criteria. Of them, 771 (0.31%) were to HBV or HCV mother carriers during pregnancy. A Kaplan-Meier curve demonstrated that children born to HBV or HCV carriers had higher cumulative incidence of respiratory morbidity (Log rank test p = 0.007). In the Cox regression model, while controlling for maternal age, diabetes mellitus, hypertensive disorders, caesarian section and gestational age at birth, maternal HBV or HCV carrier status was noted as an independent risk factor for long-term respiratory morbidity in the offspring (adjusted HR = 1.43, 95% CI 1.07-1.90, p = 0.015).

CONCLUSIONS

Maternal HBV or HCV carrier status in pregnancy may increase offspring susceptibility to long-term respiratory morbidity.

摘要

目的

母亲的乙肝病毒(HBV)或丙肝病毒(HCV)携带者状态是关乎孕期过程及短期围产期结局的一个问题。我们的主要目的是评估孕期母亲为携带者的所生孩子是否也患有长期小儿呼吸系统疾病(直至18岁)。

研究方法

在一家单一的三级医疗中心进行了一项基于人群的队列分析。该研究纳入了1991年至2014年间所有的单胎分娩,比较孕期为HBV或HCV携带者的母亲所生孩子与未暴露母亲所生孩子的呼吸道相关住院发生率。呼吸系统疾病基于一组预先定义的国际疾病分类第九版(ICD - 9)编码。采用Kaplan - Meier生存曲线比较两组间的累积住院发生率,并使用Cox回归模型对混杂变量进行校正。

结果

在研究期间,242,342例分娩符合纳入标准。其中,771例(0.31%)为孕期母亲是HBV或HCV携带者。Kaplan - Meier曲线显示HBV或HCV携带者所生孩子的呼吸系统疾病累积发生率更高(对数秩检验p = 0.007)。在Cox回归模型中,在控制母亲年龄、糖尿病、高血压疾病、剖宫产及出生孕周后,母亲的HBV或HCV携带者状态被视为后代长期呼吸系统疾病的独立危险因素(校正风险比[HR] = 1.43,95%置信区间[CI] 1.07 - 1.90,p = 0.015)。

结论

孕期母亲的HBV或HCV携带者状态可能增加后代患长期呼吸系统疾病的易感性。

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