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| Analysis of the situations of the chronic hepatitis B virus load during pregnancy and postpartum hepatitis occurrence of women, and neonatal hepatitis B virus infection |
| The Fourth People's Hospital of Zigong City, Sichuan Province, 643000 |
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Abstract To analyze the situations of the chronic hepatitis B virus (HBV) load during pregnancy and postpartum hepatitis occurrence of women, and neonatal HBV infection. Methods: The clinical data of 208 pregnant women with chronic HBV carriers from January 2019 to October 2020 were analyzed retrospectively. The women with HBV DNA ≥106 copies/mL before delivery were included in group A, and the women with HBV DNA<106 copies/mL were included in group B. The adverse outcomes of maternal and infant, the abnormal liver function rate, and the hepatitis occurrence of the women in the two groups were recorded. In the group A, the women with HBV DNA ≥500 copies/mL were included in group A1, and the women with HBV DNA <500 copies/mL were included in group A2. The situation of alanine aminotransferase (ALT) elevation of the women with different loads of HBV in the 42th d after delivery was analyzed, and the positive rates of HBV DNA in cord blood immediately after birth and in infant venous blood in the 6th month after birth was also analyzed. Results: The overall incidence of adverse outcomes of maternal and infant (33.8%), the neonatal intrauterine infection rate (20.9%), the abnormal liver function rate on the postpartum 42th day (36.7%), and the hepatitis rate (15.8%) of the women in group A were significantly higher than those (18.8%, 1.5%, 21.7%, and 5.8%) of the women in group B. The ALT level of the women in group A1 was significantly higher than that of the women in group A2 (all P<0.05). Spearman rank correlation analysis showed that the HBV DNA load of the women in group A was positively correlated with their ALT level (P<0.05). The positive rates of HBV DNA in neonatal umbilical cord blood at birth (38.1%) and in infants’ venous blood in the 6th month after birth (7.9%) in group A1 were significantly higher than those (6.6% and 0) in group A2 (all P<0.05). Conclusion: The HBV DNA load of the pregnant women with chronic HBV carriers before delivery is closely related to the degree of their abnormal liver function and their adverse maternal and infant outcomes. The pregnant women with high HBV DNA load have higher risk of mother-to-child vertical transmission of HBV and have higher risk of failure to blockade of HBV, thus it is necessary to perform proper clinical treatment for these women during the third trimester of pregnancy so as to reduce the adverse effect of high HBV load.
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