Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran.
Cardiovascular Diseases Research Center, Department of Epidemiology and Biostatistics, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran.
J Viral Hepat. 2021 Sep;28(9):1234-1245. doi: 10.1111/jvh.13565. Epub 2021 Jul 11.
Hepatitis B virus (HBV) has been considered a significant cause of human reproductive failure in different studies; however, there is a considerable disagreement on the true impacts of HBV on female reproduction. This study has evaluated the impact of HBV infection on pregnancy complications in natural pregnancy and also on pregnancy outcomes in women undergoing in vitro fertilization (IVF) treatment.
We searched Embase, Web of Science, PubMed and Google Scholar databases to identify the potentially relevant studies. Summary odds ratio (OR) or standardized mean difference (SMD) with 95% confidence interval (CI) was applied to assess the relationship. Heterogeneity testing, sensitivity analysis and publication bias testing were also performed.
A total of 42 studies concerning the effect of HBV infection on the natural and IVF pregnancy were included in this study. Our meta-analysis results revealed that HBV infection had a positive correlation to gestational diabetes mellitus (GDM) [OR = 1.32 (1.17-1.48) (p < 0.01)] and preterm birth [OR = 1.26 (1.14-1.40) (p < 0.01)] in natural pregnancy; however, HBV infection was not significantly associated with decreased fertility rates among the patients who underwent IVF.
This study revealed a strong association of GDM and preterm birth with higher rates of HBV infection in pregnant women. Also, our results suggested that HBV infection in patients undergoing IVF may not negatively influence the pregnancy outcome. It may be rational to conclude that IVF might be rather a safe and effective method for HBV+ females who desire to have children.
乙型肝炎病毒（HBV）已被认为是导致人类生殖失败的重要原因，不同研究对此观点不一；然而，HBV 对女性生殖的真实影响仍存在较大争议。本研究评估了 HBV 感染对自然妊娠妊娠并发症以及体外受精（IVF）治疗女性妊娠结局的影响。
我们检索了 Embase、Web of Science、PubMed 和 Google Scholar 数据库，以确定可能相关的研究。应用汇总优势比（OR）或标准化均数差（SMD）及其 95%置信区间（CI）来评估相关性。还进行了异质性检验、敏感性分析和发表偏倚检验。
本研究共纳入 42 项关于 HBV 感染对自然和 IVF 妊娠影响的研究。我们的荟萃分析结果表明，HBV 感染与自然妊娠中的妊娠期糖尿病（GDM）[OR=1.32（1.17-1.48）（p<0.01）]和早产[OR=1.26（1.14-1.40）（p<0.01）]呈正相关；然而，HBV 感染与接受 IVF 的患者生育率下降无关。
本研究揭示了 GDM 和早产与孕妇 HBV 感染率升高之间的强相关性。此外，我们的结果表明，接受 IVF 的患者 HBV 感染可能不会对妊娠结局产生负面影响。因此，我们可以合理地得出结论，IVF 可能是 HBV+女性想要生育的一种安全有效的方法。
