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母亲乙型肝炎病毒携带者与妊娠期糖尿病的关系:一项回顾性队列分析。

Association between maternal hepatitis B virus carrier and gestational diabetes mellitus: a retrospective cohort analysis.

机构信息

Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China.

出版信息

Virol J. 2021 Nov 20;18(1):226. doi: 10.1186/s12985-021-01691-0.

Abstract

INTRODUCTION

Given that many pregnant women have chronic hepatitis B virus (HBV) infection and that gestational diabetes mellitus (GDM) is linked to poor maternal and neonatal outcomes, we looked into the relationship between the hepatitis B surface antigen (HBsAg) and GDM to see if a high HBV DNA load is linked to a higher risk of GDM in chronic maternal HBsAg carriers.

MATERIALS AND METHODS

Our study included 39,539 pregnant women who gave birth at the Third Affiliated Hospital of Guangzhou Medical University in Guangzhou, China, between January 1, 2009, and December 31, 2019. The patients were divided into two groups: HBsAg negative (36,500) and positive (3039). The viral load levels of 1250 HBsAg-positive women who had tested their HBV DNA load during pregnancy were separated into three groups. We utilized univariate and multivariable logistical regression analysis to determine the relationship between maternal chronic HBsAg carrier and GDM.

RESULTS

Being HBsAg positive was discovered to be an independent risk factor for GDM.Pre-pregnancy Obesity and advanced age were linked to an increased incidence of GDM. Those with a high HBV DNA load (> 10 IU/mL) had a higher risk of GDM than HBsAg-positive women with a low viral load (< 10 IU/mL). Pre-eclampsia and intrahepatic cholestasis of pregnancy (ICP) appeared to be more common in HBsAg-positive women than in uninfected women.

CONCLUSIONS

Being HBsAg positive, advanced age, and pre-pregnancy obesity were all revealed to be independent risk factors for GDM in our study. In HBsAg carrier, pregnant women, a high HBV DNA burden was linked to a greater risk of GDM. Furthermore, being an HBsAg carrier during pregnancy raised the risk of ICP and pre-eclampsia.

摘要

简介

鉴于许多孕妇患有慢性乙型肝炎病毒(HBV)感染,且妊娠期糖尿病(GDM)与母婴不良结局相关,我们研究了乙型肝炎表面抗原(HBsAg)与 GDM 之间的关系,以了解高 HBV DNA 载量是否与慢性 HBsAg 携带者中 GDM 的风险增加相关。

材料和方法

我们的研究纳入了 2009 年 1 月 1 日至 2019 年 12 月 31 日期间在广州医科大学附属第三医院分娩的 39539 名孕妇。患者分为 HBsAg 阴性(36500 名)和阳性(3039 名)两组。对 1250 名 HBsAg 阳性孕妇在孕期检测 HBV DNA 载量的病毒载量水平进行分组。我们采用单变量和多变量逻辑回归分析来确定母体慢性 HBsAg 携带者与 GDM 之间的关系。

结果

HBsAg 阳性被发现是 GDM 的独立危险因素。孕前肥胖和高龄与 GDM 发生率增加有关。高 HBV DNA 载量(>10IU/mL)的患者发生 GDM 的风险高于低病毒载量(<10IU/mL)的 HBsAg 阳性患者。与未感染孕妇相比,HBsAg 阳性孕妇更易发生子痫前期和妊娠肝内胆汁淤积症(ICP)。

结论

在本研究中,HBsAg 阳性、高龄和孕前肥胖均被揭示为 GDM 的独立危险因素。在 HBsAg 携带者孕妇中,高 HBV DNA 负荷与 GDM 风险增加相关。此外,妊娠期间 HBsAg 携带增加了 ICP 和子痫前期的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2039/8605546/07a0752b9d3a/12985_2021_1691_Fig1_HTML.jpg

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