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孕产妇乙肝表面抗原携带状态与妊娠结局:一项回顾性队列研究。

Maternal hepatitis B surface antigen Carrier Status and Pregnancy Outcome: A Retrospective Cohort Study.

作者信息

Chen Yiming, Ning Wenwen, Wang Xue, Chen Yijie, Wu Bin, Tao Jie

机构信息

Department of Prenatal Diagnosis and Screening Center, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang,

Department of the Fourth school of Clinical Medical, Zhejiang Chinese Medical University, Hangzhou, Zhejiang,

出版信息

Epidemiol Infect. 2022 Apr 20;150:1-22. doi: 10.1017/S0950268822000681.

Abstract

To investigate the effect of maternal hepatitis B surface antigen (HBsAg) carrier status during pregnancy on pregnancy outcomes in a population of patients in Hangzhou, China. A retrospective cohort study was conducted to analyse data from 20 753 pregnant women who delivered at Hangzhou Women's Hospital between January 2015 and March 2020. Of these, 18 693 were normal pregnant women (the non-exposed group) and 735 were HBsAg carriers (the exposed group). We then analysed by binary multivariate logistic regression to determine the association between maternal HBsAg-positive and adverse pregnancy outcomes. The prevalence of HBsAg carriers was 3.78% and the odds ratio (OR) for maternal age in the exposed group was 1.081. Pregnant women who are HBsAg-positive in Hangzhou, China, are at higher risk of a range of adverse pregnancy outcomes, including intrahepatic cholestasis of pregnancy (ICP) (adjusted OR (aOR) 3.169), low birth weight (aOR 2.337), thrombocytopenia (aOR 2.226), fallopian cysts (aOR 1.610), caesarean scar pregnancy (aOR 1.283), foetal distress (aOR 1.414). Therefore, the obstetricians should pay particular attention to ICP, low birth weight, thrombocytopenia, fallopian cysts, caesarean scar, foetal distress in HBsAg-positive pregnant women.

摘要

为研究中国杭州地区孕妇孕期乙肝表面抗原(HBsAg)携带状态对妊娠结局的影响。开展了一项回顾性队列研究,分析2015年1月至2020年3月在杭州市妇产科医院分娩的20753名孕妇的数据。其中,18693名是正常孕妇(非暴露组),735名是HBsAg携带者(暴露组)。然后通过二元多因素逻辑回归分析来确定孕妇HBsAg阳性与不良妊娠结局之间的关联。HBsAg携带者的患病率为3.78%,暴露组孕妇年龄的比值比(OR)为1.081。在中国杭州,HBsAg阳性孕妇出现一系列不良妊娠结局的风险更高,包括妊娠期肝内胆汁淤积症(ICP)(校正OR(aOR)为3.169)、低出生体重(aOR为2.337)、血小板减少症(aOR为2.226)、输卵管囊肿(aOR为1.610)、剖宫产瘢痕妊娠(aOR为1.283)、胎儿窘迫(aOR为1.414)。因此,产科医生应特别关注HBsAg阳性孕妇的ICP、低出生体重、血小板减少症、输卵管囊肿、剖宫产瘢痕、胎儿窘迫情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3061/9102056/302d55d4ddf1/S0950268822000681_fig1.jpg

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