Prevalence of Hepatitis B Carrier Status and Its Negative Association with Hypertensive Disorders in Pregnancy

Background and Objectives. To evaluate whether a negative association between chronic hepatitis B carrier status and hypertensive disorders in pregnancy could continue to be demonstrated in an endemic area with a changing prevalence for chronic hepatitis B infection. Study Design. A retrospective cohort of all deliveries in a single centre over a period of 20 years in a population with high prevalence for chronic hepatitis B carrier status was studied. Main Outcome Measures. The primary outcome was the prevalence of chronic HBV carrier status and gestational hypertensive disorders in pregnancy during the study period. The secondary outcome measures included the major risk factors for gestational hypertensive disorders. The overall association between HBV carrier status and gestational hypertensive disorders and the association with major risk factors were then evaluated. Results. In a total cohort of 87889 deliveries over a period of 20 years, the prevalence rate of HBV fell from around 10-11% to around 6-7% in the last 5 years of the study. A negative association between chronic HBV carrier status and all gestational hypertensive disorders could be demonstrated. An apparent protective effect of HBV carrier status was apparently more robust against preeclampsia than gestational hypertension, as the negative association with preeclampsia was consistently observed throughout the study period. A logistic regression model showed that advanced maternal age, multiple pregnancies, obesity, and significant medical disorders were positively correlated with gestational hypertensive disorders, while multiparity and positive HBV carrier status were negatively correlated. Conclusion. Chronic HBV carrier status appeared to have a protective effect against the development of preeclampsia and gestational hypertension in an endemic area with high HBV prevalence rates.

Epidemiology of hepatitis B in the Islamic Republic of Iran

Hepatitis B virus, a common cause of viral hepatitis, consumes a large portion of health resources in developing countries. Data obtained from the Survey of Health and Disease in the Islamic Republic of Iran were analysed with respect to hepatitis B-carrier epidemiology. Since the precise mode of transmission of hepatitis B is not well known, the study was designed to evaluate its transmission as a community-acquired disease. HBsAg tests were performed on the sera of 39 841 persons and the impact of several factors on the prevalence rate of HBV carriers was determined. The rate of hepatitis B carriers varied between zero and 3.9% with an average of 1.7%. Older males living in a village with low socioeconomic status, poor sanitation and intrafamily contact are the most important contributors to the rise of hepatitis B infection in the country

INACTIVE HEPATITIS B CARRIER AND PREGNANCY OUTCOMES

Objective: To assess the impact of hepatitis B carrier status on pregnancy and perinatal outcome. Study Design: Cross sectional study. Place and Duration of Study: Department of Gynaecology and Obstetrics, Pakistan Naval Ship Shifa Hospital,Karachi, from Feb 2017 to Jan 2018. Methodology: A total of 9526 women delivered during study period. 9305 women fulfilling the inclusion criteriawere included in study. Two hundred and twenty one (221) women were excluded because of not fulfilling theinclusion criteria. Out of study group, 9104 women were HBsAg negative while 201 had positive hepatitis Bcarrier status. Antenatal complications (such as gestational diabetes, gestational hypertension, pre eclampsia),mode of delivery (vaginal delivery, elective cesarean, emergency cesarean) and perinatal outcomes (pretermdelivery, low birth weight at delivery, live birth rate, APGAR score at 1 and 5 min) were observed amonghepatitis B carrier and noncarrier. Results: There was no significant difference in point prevalence of major antenatal complications, mode ofdelivery and perinatal outcomes in HBsAg carriers and noncarriers. A slightly higher rate of preterm birth wasobserved in hepatitis B carriers (4.9%) as compared to noncarriers (2.6%). Conclusion: Hepatitis B carriers have slightly increased risk of preterm delivery.

A Meta–Analysis and Systematic Review to Determine the Pregnancy Outcomes in Mothers with inactive Hepatitis B Carrier

Objective: Our goal was to investigate whether asymptomatic maternal hepatitis B (HB) infection affects early membrane rupture (PROM), fetal death, preeclampsia, eclampsia, gestational hypertension, or bleeding before delivery. Materials and Methods: This study was conducted in the Department of Community Medicine and Obstetrics and Gynecology department, KEMU Lahore for one-year duration from May 2017 to April 2018. The electronic literature surveys were conducted using gray literature studies (e.g. conference papers and final reports). (Technicians) and scanned reference lists of attached studies and systematically related studies. We study statistical heterogeneity using statistical tests I2 and tau square (Tau2). Results: 18 studies included. Early membrane ruptures (PROM), fetal death, preeclampsia, eclampsia, gestational hypertension and prenatal bleeding were obtained in this study. The results showed no significant relationship between inactive HB and these complications during pregnancy. Small amounts of P and chi-square and large amounts of I2 have revealed heterogeneity, which we are trying to modify using statistical methods such as subgroup analysis in this chapter. Conclusion: Inactive HB infection did not increase the risk of adverse effects in this study. In addition, well-designed tests should be performed to confirm the results.

Maternal and Perinatal Outcomes in women with Hepatitis B Carrier State

Introduction Hepatitis B is the most common form of viral hepatitis. Much has been done for the prevention of Hepatitis B transmission from mother to child. However, there is still very limited evidence looking at maternal obstetrics and perinatal outcomes, such as gestational diabetes, antepartum haemorrhage and preterm labour, hypertensive disorders in pregnancy and small for gestational age, with Hepatitis B infected women. These adverse pregnancy outcomes, if significant, may affect future antenatal care and have a negative impact on public health. This study aims to determine the association between these adverse pregnancy and neonatal outcomes with maternal Hepatitis B carrier state. Methods This is a retrospective cohort study comparing adverse pregnancy and neonatal outcomes in primigravid women who delivered singleton babies after 24 completed weeks of gestation and are carrier for Hepatitis B virus with those who are non-carrier for Hepatitis B virus, between 1992 and 2013 in Aberdeen Maternity Hospital. The adverse pregnancy and neonatal outcomes studied include hypertensive disorders in pregnancy, antepartum haemorrhage, preterm birth <37 weeks, induction of labour, caesarean delivery, low birth weight and admission to neonatal unit. Data was extracted from the Aberdeen Maternity and Neonatal Databank (AMND), which was established in 1950 to record all pregnancy-related events occurring in Aberdeen city and district in the northeast of Scotland. Statistical analysis was done with SPSS version 21 using independent samples t-test for normally distributed continuous variables and chi-squared test for categorical variables. Multivariate logistic regression analysis using a multilevel random effects regression model was also conducted to adjust for confounding factors. Results The data set contained a sample size of 35116 primigravid women with singleton pregnancies, with 59 being carrier for Hepatitis B virus (represented by positive HBsAg status). HBsAg-positive women had significantly lower mean Body Mass Index and were more likely to be from the manual social class (registrar general’s occupation-based social class). On unadjusted analysis, there were no significant differences in the prevalence of all maternal and perinatal outcomes in both groups. However, after adjusting for confounding factors, HBsAg-positive women were more likely to have smaller babies (aOR 4.28; 95% CI 1.57-11.66). Conclusion Our study suggested higher frequencies of low birth weight babies in women with hepatitis B infection. We found no statistically significant differences in other adverse pregnancy and perinatal outcomes. As current evidence still shows inconsistent results, further research evaluating the possible effects of Hepatitis B viraemia on pregnancy outcomes is justified.