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[慢性乙型肝炎病毒感染对妊娠中晚期及产后孕妇健康相关生活质量的影响:一项前瞻性队列研究]

[Chronic HBV infection affects health-related quality of life in pregnant women in the second and third trimesters and postpartum period: a prospective cohort study].

作者信息

Deng Yueying, Geng Yawen, Peng Tingting, Qiu Junchao, He Lijuan, Xie Dan, Chen Ziren, Ouyang Shi, Yan Shengguang

机构信息

School of Public Health, North China University of Science and Technology, Tangshan 063210, China.

Department of Infectious Diseases.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2025 May 20;45(5):995-1002. doi: 10.12122/j.issn.1673-4254.2025.05.12.

Abstract

OBJECTIVES

To evaluate the impact of HBV infection on pre- and postpartum health-related quality of life (HRQoL) in pregnant women.

METHODS

A prospective matched cohort consisting of 70 HBV-infected and 70 healthy pregnant women was recruited from the Fifth Affiliated Hospital of Guangzhou Medical University between April 17 and September 25, 2023. HRQoL of the participants was assessed at 16-24 weeks of gestation, between 32 weeks and delivery, and 5-13 weeks postpartum. Mixed linear models were used for evaluating temporal trends of HRQoL changes, and univariate ANOVA with multiple linear regression was used to identify the predictors of HRQoL.

RESULTS

Compared with healthy pregnant women, HBV-infected pregnant women had consistently lower total HRQoL scores across all the 3 intervals, with the lowest scores observed between 32 weeks of gestation and delivery, during which these women had significantly reduced mental component scores (74.27±13.43 80.21±12.9, =0.009) and postpartum mental (76.52±16.19 85.02±6.51, <0.001) and physical component scale scores (77.17±14.71 83.09±10.1, =0.009). HBV infection was identified as an independent risk factor affecting HRQoL during late pregnancy and postpartum periods. Additional independent risk factors for postpartum HRQoL reduction included self-pay medical expenses, spouse's neutral attitude toward the current pregnancy, and preexisting comorbidities (all <0.05).

CONCLUSIONS

HRQoL of pregnant women deteriorates progressively in late pregnancy, and HBV infection exacerbates reductions of physical function and role emotion in late pregnancy and after delivery, suggesting the importance of targeted interventions for financial burdens, partner support and comorbid conditions to improve HRQoL of pregnant women with HBV infection.

摘要

目的

评估乙肝病毒(HBV)感染对孕妇产前和产后健康相关生活质量(HRQoL)的影响。

方法

2023年4月17日至9月25日期间,从广州医科大学第五附属医院招募了一个前瞻性匹配队列,其中包括70名HBV感染孕妇和70名健康孕妇。在妊娠16 - 24周、32周与分娩之间以及产后5 - 13周对参与者的HRQoL进行评估。采用混合线性模型评估HRQoL变化的时间趋势,并使用单因素方差分析和多元线性回归来确定HRQoL的预测因素。

结果

与健康孕妇相比,HBV感染孕妇在所有3个时间段的总HRQoL得分始终较低,在妊娠32周与分娩之间得分最低,在此期间这些女性的心理成分得分显著降低(74.27±13.43对80.21±12.9,P = 0.009),产后心理(76.52±16.19对85.02±6.51,P < 0.001)和身体成分量表得分(77.17±14.71对83.09±10.1,P = 0.009)。HBV感染被确定为影响妊娠晚期和产后HRQoL的独立危险因素。产后HRQoL降低的其他独立危险因素包括自费医疗费用、配偶对当前妊娠的中立态度以及既往合并症(均P < 0.05)。

结论

孕妇的HRQoL在妊娠晚期逐渐恶化,HBV感染加剧了妊娠晚期和分娩后身体功能和角色情绪的下降,这表明针对经济负担、伴侣支持和合并症进行有针对性干预对于改善HBV感染孕妇的HRQoL具有重要意义。

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Health-related quality of life in different trimesters during pregnancy.妊娠期不同孕期的健康相关生活质量。
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本文引用的文献

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Health-related quality of life in different trimesters during pregnancy.妊娠期不同孕期的健康相关生活质量。
Health Qual Life Outcomes. 2021 Jul 21;19(1):182. doi: 10.1186/s12955-021-01811-y.

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