Does Maternal Chronic Hepatitis B Virus Infection Increase Pregnancy and Fetal Risks?

Abstract

Aim: More than 400 million people worldwide are infected with the hepatitis B virus (HBV). The effect of HBV infection on pregnant women is unclear. The presence of chronic HBV in pregnancy has been reported to increase such maternal and fetal risks as gestational diabetes, antepartum hemorrhage, prematurity, neonatal jaundice, and low birth weight. The purpose of this study was to investigate the effects of HBV on pregnancy and fetal risks.

Materials-Methods: Three hundred and one pregnant women infected with HBV and giving live birth in our hospital in 2014-2017, and their babies, were enrolled as the case group, while randomly selected pregnant women giving live birth in our hospital and not infected with HBV, and their babies, were included as the control group. Maternal and fetal outcomes such as type of delivery, miscarriage, re-eclampsia, gestational diabetes, antepartum hemorrhage, fetal distress, gestational weeks, and intrauterine growth restriction (IUGR) were analyzed retrospectively from patients’ records.

Results: Delivery was by the normal vaginal route in 189 (62.8%) of the 301 HBsAg-positive women in the study, while diabetes was present in 4 (1.3%), pre-eclampsia in 2 (0.7%), a history of miscarriage in 82 (27.2%), and placental detachment in 5 (1.7%). No statistically significant difference was determined between these and the HBsAg-negative women (p>0.05). IUGR was present in the babies of 6 (2%) of HBsAg(+) mothers, and fetal distress in 12 (40%). The presence of fetal distress was significantly higher in the babies of HBsAg(+) mothers (p:0.036).

Conclusion: Although several studies have shown that HBV infection increases maternal and fetal risks, only the risk of fetal distress was significant in our study. The noteworthy finding of our study is that the presence of HBV did not affect the physician’s decision regarding type of delivery.

Keywords

• pregnancy,fetal,risk,hepatitis B infection

Maternal Kronik Hepatit B Virüs Enfeksiyonu Gebelik ve Fetal Riskleri Artırıyor Mu?

Abstract

Amaç: Dünyada 400 milyondan fazla kişi Hepatit B virüs (HBV)’ü ile enfektedir. Hepatit B virüs enfeksiyonun gebeler üzerindeki etkisi  açık değildir. Gebelikte Kronik HBV varlığının gestasyonel diyabet, antepartum hemoraji, erken doğum tehdidi, yenidoğan sarılığı, düşük doğum ağırlığı gibi maternal ve fetal riskleri artırdığı belirtilmektedir. Bu çalışmanın amacı HBV’nün gebelik ve fetal riskler üzerine etkilerini araştırmaktır.

Gereç-Yöntem: 2014-2017 yılları arasında hastanemizde canlı doğum yapan HBV ile enfekte 301 gebe ve bebeği vaka grubu; aynı yıllarda  rastgele seçilen, hastanemizde canlı doğum  yapan HBV ile enfekte olmayan gebeler ve bebekleri kontrol grubu olarak  çalışmamıza dahil edildi. Retrospektif olarak hasta dosyalarından doğum şekli, abortus, preeklampsi, gestasyonel diyabet, antepartum hemoraji, fetal distres, gebelik haftası, doğum ağırlığı, intrauterin gelişme geriliği(IUGR) gibi maternal ve fetal sonuçları analiz edildi.

Bulgular: Çalışmaya dahil edilen 301 HBsAg pozitif gebe kadının 189(%62,8)’inin doğum şekli normal vajinal doğum olup, 4(%1,3)’ü diyabet, 2(%0,7)’i preeklampsi, 82(%27,2)’inde abortus öyküsü ve 5(%1,7)’inde plesanta dekolmanı mevcuttu. HBsAg negatif hastalarla arasında istatistisel olarak anlamlı fark tespit edilmedi(p>0,05). HBsAg(+) annenin 6(%2) bebeğinde IUGR ve 12(%40)’ında fetal distres vardı. HBsAg(+) anne bebeklerinde fetal distres varlığını istatistiksel olarak anlamlı fark tespit ettik(p:0,036).

Sonuç: Yapılmış bir çok çalışmada HBV enfeksiyonunun maternal ve fetal komplikasyonları artırdığı gösterilmiş olmasına rağmen çalışmamızda yalnızca fetal distres riskini anlamlı olarak bulduk. Çalışmamızda dikkat çeken nokta HBV varlığının hekimin doğum şekline karar vermesini etkilemediğini gördük.

Keywords

• gebelik,fetal,risk,hepatit B enfeksiyonu

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