Wu Jian, Wang Huiqing, Xiang Ze, Jiang Chun, Xu Yunyang, Zhai Guanghua, Ling Zongxin
Department of Blood Transfusion, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 242 Guangji Road, Suzhou 215008, Jiangsu Province, China.
Department of Family Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China.
J Transl Int Med. 2024 Oct 1;12(4):344-354. doi: 10.2478/jtim-2024-0015. eCollection 2024 Sep.
Hepatitis viral infection can cause severe complications, even mortality in pregnant women and their offspring. Multiple studies have shown that vertical transmission can cause viral hepatitis infections in newborns, especially in hepatitis B, C, and E. Screening for hepatitis viral infection in pregnant women is essential. Once infected, pregnant women should be given timely antiviral treatments, which could effectively alleviate the disease progression and reduce adverse outcomes. Besides, the mechanism of viral hepatitis mediating adverse pregnancy outcomes has been a hot topic. Hepatitis B virus has been found to mediate both mother- to-child and parent-child transmission. Liver injury in hepatitis C virus infection is associated with immune-mediated mechanisms, which can be regulated by hormonal factors as well. The mediating mechanism of adverse maternal and infant outcomes caused by hepatitis E virus infection is mainly related to viral replication in the placenta and changes in cytokine and estrogen. Nevertheless, the specific mechanisms related to hepatitis A virus and hepatitis D virus remain unclear, and more research is needed. This review shows that the existence of viral hepatitis during pregnancy can pose certain risks for pregnant women and infants, and different interventions have been used to treat pregnant women infected with viral hepatitis. It may provide deep insight into adverse pregnancy outcomes caused by viral hepatitis and give guidance on treatment.
病毒性肝炎感染可导致严重并发症,甚至导致孕妇及其后代死亡。多项研究表明,垂直传播可导致新生儿感染病毒性肝炎,尤其是乙型、丙型和戊型肝炎。对孕妇进行病毒性肝炎感染筛查至关重要。一旦感染,应及时给予孕妇抗病毒治疗,这可有效缓解疾病进展并减少不良后果。此外,病毒性肝炎介导不良妊娠结局的机制一直是热门话题。已发现乙型肝炎病毒介导母婴传播和亲子传播。丙型肝炎病毒感染中的肝损伤与免疫介导机制有关,激素因素也可对其进行调节。戊型肝炎病毒感染导致母婴不良结局的介导机制主要与病毒在胎盘中的复制以及细胞因子和雌激素的变化有关。然而,与甲型肝炎病毒和丁型肝炎病毒相关的具体机制仍不清楚,需要更多研究。本综述表明,孕期病毒性肝炎的存在会给孕妇和婴儿带来一定风险,并且已采用不同干预措施治疗感染病毒性肝炎的孕妇。它可能为病毒性肝炎导致的不良妊娠结局提供深入见解并为治疗提供指导。