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慢性乙型肝炎感染母亲的患者报告结局:一项横断面分析。

Patient-reported outcomes in mothers with chronic hepatitis B infection: A cross-sectional analysis.

作者信息

OuYang Shi, Deng Yueying, Geng Yawen, Yuan Xiaoli, Peng Tingting, Qiu Junchao, Xiao Zhirong, Yan Shengguang, Deng Haitao, Peng Xiaotong, Pan Calvin Q

机构信息

Department of Infectious Diseases, Key Laboratory of Biological Targeting Diagnosis, Therapy, and Rehabilitation of Guangdong Higher Education Institutes, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China.

Department of Infectious Diseases, Key Laboratory of Biological Targeting Diagnosis, Therapy, and Rehabilitation of Guangdong Higher Education Institutes, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China; School of Public Health, North China University of Science and Technology, Tangshan, PR China.

出版信息

Clin Res Hepatol Gastroenterol. 2025 Mar;49(3):102537. doi: 10.1016/j.clinre.2025.102537. Epub 2025 Jan 25.

Abstract

BACKGROUND & AIMS: The health-related quality of life (HRQoL) during pregnancy has not been well-lidated in mothers with chronic hepatitis B (CHB). We aim to compare patient-reported outcomes (PROs) in CHB mothers with those of healthy mothers during pregnancy.

METHODS

Between 4/16/2023 and 7/31/2023, we invited consecutive CHB and healthy mothers to complete the self-administered 36-item Short Form Survey (SF-36) and the Chronic Liver Disease Questionnaire (CLDQ) for PRO assessment. Pairwise comparisons of PRO scores between groups were performed using chi-square tests. Covariates for worse PROs were further analyzed by the multiple linear regression model to identify the independent predictors RESULTS: Among 257 participants (CHB: healthy control was 100:157), the mean (SD) age was 29.6 (3.4), and the majority completed the PRO assessment at the gestational weeks of 16-24. When compared to healthy mothers, CHB mothers had a significant impairment of PROs in the CLDQ domain of worry (6.97±0.16 vs 5.83±0.99, p<0.05) and the SF-36 domain of social functioning (95.33±10.00 vs 91.67±16.37, p<0.05). The subgroup analyses in CHB mothers showed HBV DNA >200,000 IU/mL associated with significantly worse PROs. The multivariate analyses identified CHB infection, severe nausea or vomiting, poor living conditions, and spousal negative attitude as independent predictors of HRQoL impairment.

CONCLUSION

This study suggests that CHB infection during pregnancy negatively impacted HRQoL, particularly in worry and social functioning domains. CHB infection was an independent predictor for PRO impairments. Further integration of monitoring and intervention on HRQoL impairment should be considered when managing CHB mothers during pregnancy.

摘要

背景与目的

慢性乙型肝炎(CHB)母亲孕期的健康相关生活质量(HRQoL)尚未得到充分验证。我们旨在比较CHB母亲与健康母亲孕期的患者报告结局(PROs)。

方法

在2023年4月16日至2023年7月31日期间,我们邀请连续就诊的CHB母亲和健康母亲完成用于PRO评估的36项简短问卷调查表(SF - 36)和慢性肝病问卷(CLDQ)。使用卡方检验对组间PRO得分进行成对比较。通过多元线性回归模型进一步分析PRO较差的协变量,以确定独立预测因素。结果:在257名参与者中(CHB:健康对照为100:157),平均(标准差)年龄为29.6(3.4)岁,大多数人在妊娠16 - 24周时完成了PRO评估。与健康母亲相比,CHB母亲在CLDQ的担忧领域(6.97±0.16对5.83±0.99,p<0.05)和SF - 36的社会功能领域(95.33±10.00对91.67±16.37,p<0.05)的PRO有显著损害。CHB母亲的亚组分析显示,HBV DNA>200,000 IU/mL与显著更差的PRO相关。多变量分析确定CHB感染、严重恶心或呕吐、生活条件差以及配偶的消极态度是HRQoL损害的独立预测因素。

结论

本研究表明,孕期CHB感染对HRQoL有负面影响,尤其是在担忧和社会功能领域。CHB感染是PRO损害的独立预测因素。在孕期管理CHB母亲时,应考虑进一步整合对HRQoL损害的监测和干预。

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