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乙肝病毒感染的母亲对接受辅助生殖技术治疗的妇女妊娠并发症和新生儿结局的影响:一项基于人群的研究。

Impact of maternal infection with hepatitis B virus on pregnancy complications and neonatal outcomes for women undergoing assisted reproductive technology treatment: A population-based study.

机构信息

Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.

Xiamen Health Commission, Xiamen, China.

出版信息

J Viral Hepat. 2021 Apr;28(4):613-620. doi: 10.1111/jvh.13472. Epub 2021 Feb 16.

Abstract

The aim of this study was to investigate the impact of maternal hepatitis B virus (HBV) status on pregnancy complications and neonatal outcomes for women undergoing assisted reproductive technology (ART). A total of 7,011 pregnancies achieved by ART were included from a population-based database involving 523,111 pregnancies. Exposures of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) among pregnant women were routinely tested at the first antenatal visit for all pregnancies. We collected pregnancy complications (e.g., gestational diabetes mellitus [GDM], intrahepatic cholestasis of pregnancy [ICP]), neonatal outcomes and confounding variables from the same database. Univariate and multivariate analyses by adjusting confounders were conducted to evaluate the impact of maternal HBV infection. Prevalence of HBsAg seropositivity (HBsAg+) was 11.34% (95% CI 10.6-12.1) and that of HBsAg and HBeAg co-seropositivity (HBsAg+HBeAg+) was 2.55% (2.1-3.0) among included population. Compared with HBsAg-group, ICP risk in the HBsAg+group was higher (4.03% vs. 1.79%; adjusted odds ratio [aOR] 2.49, 1.65-3.77). Similarly, ICP prevalence in the HBsAg+HBeAg+ group was higher than that in the HBsAg-HBeAg- group (6.47% vs. 1.61%; aOR 4.78, 2.28-9.98). No associations were found between maternal HBV infection (i.e., HBsAg+, HBsAg+HBeAg+, or HBsAg+HBeAg-) and other adverse outcomes for women undergoing ART (i.e., GDM, pre-eclampsia, placental previa, premature separation of placenta, premature rupture of membranes, preterm birth and low birthweight) in this study. In conclusion, maternal HBV infection (HBsAg+or HBsAg+HBeAg+) probably increase ICP risk, but may not associate with other pregnancy complications or neonatal outcomes for pregnant women who underwent ART.

摘要

本研究旨在探讨乙型肝炎病毒(HBV)感染母亲对接受辅助生殖技术(ART)的孕妇妊娠并发症和新生儿结局的影响。本研究从一个包含 523111 例妊娠的基于人群的数据库中纳入了 7011 例通过 ART 实现的妊娠。所有孕妇在首次产前检查时均常规检测乙型肝炎表面抗原(HBsAg)和乙型肝炎 e 抗原(HBeAg)。我们从同一数据库中收集了妊娠并发症(如妊娠期糖尿病[GDM]、妊娠肝内胆汁淤积症[ICP])、新生儿结局和混杂变量。通过调整混杂因素进行单因素和多因素分析,以评估母体 HBV 感染的影响。纳入人群中 HBsAg 血清阳性(HBsAg+)的患病率为 11.34%(95%CI 10.6-12.1),HBsAg 和 HBeAg 共同血清阳性(HBsAg+HBeAg+)的患病率为 2.55%(2.1-3.0)。与 HBsAg 组相比,HBsAg+组 ICP 风险更高(4.03%比 1.79%;调整后的比值比[aOR] 2.49,1.65-3.77)。同样,HBsAg+HBeAg+组的 ICP 患病率高于 HBsAg-HBeAg-组(6.47%比 1.61%;aOR 4.78,2.28-9.98)。本研究中,接受 ART 的孕妇(即 HBsAg+、HBsAg+HBeAg+或 HBsAg+HBeAg-)的母体 HBV 感染(即 HBsAg+或 HBsAg+HBeAg+)与其他不良结局(即 GDM、子痫前期、前置胎盘、胎盘早剥、胎膜早破、早产和低出生体重)之间无关联。总之,母体 HBV 感染(HBsAg+或 HBsAg+HBeAg+)可能会增加 ICP 风险,但与接受 ART 的孕妇的其他妊娠并发症或新生儿结局无关。

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