Antiviral Therapy for Chronic Hepatitis B in Pregnancy
The impact of CHB on pregnancy outcomes has not been clearly defined. Most published data have suggested that CHB negatively impacts maternal outcomes. Possible associations have been described between CHB and gestational diabetes mellitus, antepartum hemorrhage, increased risk of prematurity, and lower birth weight. A retrospective study by Lao et al reported that a significantly higher prevalence of gestational diabetes mellitus was found in mothers with HBsAg positivity (n = 1138) when compared with those (n = 12,547) without CHB. In a case-control retrospective study by Tse et al, HBsAg positive mothers (n = 253) were compared with HBsAg negative mothers (n = 253), matched by age, parity, and year of delivery. They observed that maternal HBsAg positivity was associated with increased antepartum hemorrhage, gestational diabetes, and threatened preterm labor.
Data are conflicting regarding fetal outcomes from maternal CHB infection. Recent studies suggest that maternal CHB infection was associated with preterm labor, perinatal mortality, congenital malformations, and low birth weight. Conversely, one large retrospective study compared 824 HBsAg-positive mothers to 6281 HBsAg-negative controls. No differences were seen in gestational age at delivery, birth weight, neonatal jaundice, congenital anomalies, incidence of prematurity, or perinatal mortality. Other studies have shown that the strength of these associations is still unclear. A significant adverse neonatal outcome is the development of fulminant hepatitis in some newborns when HBV is transmitted from HBeAg-negative mothers. The impact of CHB on the infant's outcome is further discussed in the Mother-to-Child Transmission of HBV section.
Maternal and Fetal-Neonatal Outcomes
The impact of CHB on pregnancy outcomes has not been clearly defined. Most published data have suggested that CHB negatively impacts maternal outcomes. Possible associations have been described between CHB and gestational diabetes mellitus, antepartum hemorrhage, increased risk of prematurity, and lower birth weight. A retrospective study by Lao et al reported that a significantly higher prevalence of gestational diabetes mellitus was found in mothers with HBsAg positivity (n = 1138) when compared with those (n = 12,547) without CHB. In a case-control retrospective study by Tse et al, HBsAg positive mothers (n = 253) were compared with HBsAg negative mothers (n = 253), matched by age, parity, and year of delivery. They observed that maternal HBsAg positivity was associated with increased antepartum hemorrhage, gestational diabetes, and threatened preterm labor.
Data are conflicting regarding fetal outcomes from maternal CHB infection. Recent studies suggest that maternal CHB infection was associated with preterm labor, perinatal mortality, congenital malformations, and low birth weight. Conversely, one large retrospective study compared 824 HBsAg-positive mothers to 6281 HBsAg-negative controls. No differences were seen in gestational age at delivery, birth weight, neonatal jaundice, congenital anomalies, incidence of prematurity, or perinatal mortality. Other studies have shown that the strength of these associations is still unclear. A significant adverse neonatal outcome is the development of fulminant hepatitis in some newborns when HBV is transmitted from HBeAg-negative mothers. The impact of CHB on the infant's outcome is further discussed in the Mother-to-Child Transmission of HBV section.
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