The Effects Of Antiviral Therapy With Telbivudine On Placenta Function And The Outcome Of The Newborns

OBJECTIVE:To investigate the effect of telbivudine antiviral therapy on placental function and neonatal outcome in pregnant women with high viral load.Methods:120 cases of pregnant women with HBsAg and HBeAg double positive and HBVDNA?1 x 107copies/ml were divided into treatment group(group A),control group(group B)according to the patient's intention,group A was treated with telbivudine 600mg,Once a day orally,to the time of childbirth.Group B was not treated with any antiviral drugs.A pregnant group without HBV infection was selected as the normal control group(group C).Each group of 60 cases.Pregnant women in each group were taken serum free estriol(FE3)Placenta prolactin(HPL),serum HBVDNA level and color Doppler umbilical cord blood flow S/D ratio determinations at the beginning of treatmatent(24 to 28 weeks pregnant),and before delivery.The levels of hepatocyte growth factor(HGF)mRNA expression in placenta tissues were measured after delivery.Observe the above indicators in the three groups of differences and neonatal outcomes.Results:Compared witheach other,there was no significant difference in serum FE3,HPL level and placental cord blood flow S/D ratio among the three groupsat the beginning of treatmatent(24 to 28 weeks pregnant),and before delivery(P>0.05).Before delivery,the serum HBVDNA level in group A was lower than that in group B(P<0.05).The quantitative value of serum HBVDNA in group A was lower than that before treatment(P<0.05).The relative value of HGFmRNA in group A was lower than that in group B,but the difference was not statistically significant(P>0.05)There were no deformed children found in each group.Compared with each other,there were no significant differences in neonatal gestational age,birth weight,head circumference and Apgar scores among the three groups(P>0.05).The positive rate of serum HBVDNA in group A was lower than that in group B(0%vs.6.67%)at birth and 7 months.the difference was statistically significant(P<0.05)Conclusions:The anti-viral treatment of telbivudine had no significant effect on the maternal placental function.Telbivfine significantly reduced the level of HBV-DNA in the peripheral blood of mothers,effectively reduced the risk of mother-to-child transmission,and had no adverse effect on neonatal outcomes.and the recent safety is good.