Analysis Of The Influence Of HBV Infection On Pregnancy And Related Factors Of Adverse Pregnancy Outcome

Objective:To explore the effects of hepatitis B virus(HBV)infection on the adverse pregnancy outcome of pregnant women and its other related factors,so as to provide reference for the management of pregnant women with HBV infection and the reduction of adverse pregnancy outcome,and to provide ideas for the follow-up research.Methods:From June 2008 to October 2017,HBsAg positive pregnant women and normal pregnant women and their newborns were enrolled in our study at Wuhan Womenn and Children Medical and Health care Center.The influencing factors of different pregnancy outcomes(hypertensive disorder complicating pregnancy(HDCP),gestational diabetes mellitus(GDM),postpartum hemorrhage and fetal distress)in hepatitis B pregnant women and non-hepatitis B pregnant women were analyzed.Using independent sample t test,?~2 test,Fisher's exact test and multivariate logistic regression analysis,the influence of HBV infection on adverse pregnancy outcome and other related factors were analyzed.Results:1.A total of 5172 perinatal health questionnaires were collected,including 2761pairs of HBsAg positive mothers and their newborns(hepatitis B group)and 2411pairs of HBsAg negative mothers and their newborns(normal group).There were differences in some general characteristics(age,occupation,education,first delivery and abnormal pregnancy history)between two groups.2.The above-mentioned differences between hepatitis B and normal pregnant women and the clear influencing factors of each adverse pregnancy outcome were adjusted in logistic regression analysis,and the adjusted odds ratio(aOR)was calculated.We found that HBsAg positive may be associated with an increased risk of adverse pregnancy outcomes:hypertensive disorder complicating pregnancy(aOR95%CI:2.731(1.775,4.203)),pregnancy diabetes(aOR 95%CI:1.958(1.349,2.843)),cesarean section(a OR 95%CI:1.648(1.465,1.855)),postpartum hemorrhage(aOR95%CI:1.742(1.199,2.533)),fetal distress(aOR 95%CI:1.438(1.141,1.812)).3.The influencing factors of HDCP:multipara is a protective factor for HDCP.The age of pregnant women?35 years old,family history of hypertension,prenatal BMI?28 kg/m2,and HBsAg positive were risk factors for HDCP,the OR and 95%CI were 1.331(1.044,1.696),2.421(1.439,4.072),1.634(1.094,2.442),2.768(1.802,4.251),respectively.4.The influencing factors of GDM:the age of pregnant women?35 years old,family history of diabetes,liver function abnormalities of hepatitis B pregnant women were risk factors,the OR and 95%CI were 1.890(1.475,2.420),1.467(1.011,2.128),2.892(1.436,5.825),2.561(1.703,3.853),respectively.5.The influencing factors of postpartum hemorrhage:Multivariate logistic regression analysis showed that cesarean section was a protective factor for postpartumhemorrhage(OR95%CI:0.383(0.263,0.556)),whereasprenatal BMI,anaemia during pregnancy,placenta previa,placenta accreta,and HBsAg positive were risk factors of postpartum hemorrhages,and the OR and 95%CI were1.528(1.035,2.256),3.440(1.495,7.913),6.982(3.482,14.003),3.064(1.740,5.395),1.853(1.273,2.699),respectively.6.The influencing factors of fetal distress:Multivariate logistic regression analysis showed that amniotic fluid turbidity,umbilical cord abnormalities,and HBsAg positive were risk factors for fetal distress,with OR and 95%CI were2.480(2.277,2.702),1.448(1.133,1.851),1.352(1.098,1.665),respectively.Conclusion:1.HBV infection has an impact on adverse pregnancy outcomes and was an independent risk factor for pregnancy-induced hypertension,gestational diabetes mellitus,postpartum hemorrhage and fetal distress.2.There are different numerous influencing factors for different adverse pregnancy outcomes.In our study,in addition to HBV infection,there are other related factors related to the adverse pregnancy outcome.Adverse pregnancy outcomes and their related factors were as follows,(1)HDCP:parity,age of pregnant women,family history of hypertension,prenatal BMI;(2)GDM:age of pregnant women and family history of diabetes;(3)postpartum hemorrhage:cesarean section,prenatal BMI,anemia during pregnancy,placental factors(placenta previa,placenta accreta);(4)fetal distress:amniotic fluid turbidity,umbilical cord abnormalities.