Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 14 , ISSUE 4 ( July-August, 2022 ) > List of Articles

Original Article

Perinatal Outcomes of Patients with Hepatitis B Viral Infection in Pregnancy

Christy Vijay, Ashima K Thuruthayil, Annamma Thomas

Keywords : Hepatitis B, Hepatitis B surface antigen, Lower-segment cesarean section, Pregnancy, Prematurity

Citation Information : Vijay C, Thuruthayil AK, Thomas A. Perinatal Outcomes of Patients with Hepatitis B Viral Infection in Pregnancy. J South Asian Feder Obs Gynae 2022; 14 (4):349-355.

DOI: 10.5005/jp-journals-10006-2015

License: CC BY-NC 4.0

Published Online: 22-08-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Purpose: Hepatitis B virus (HBV) virus has been established to infect about 350 million individuals on a worldwide scale. Nearly half of the infection is acquired either perinatally or in early childhood. The infection represents a significant cause of cirrhosis and hepatocellular carcinoma–related morbidity and mortality. Materials and methods: This is a retrospective record study conducted at a tertiary care hospital (St John's Medical College Hospital, Bengaluru) by review of records over the past 5 years (January 2015–June 2021). Results: We identified 85 pregnant women diagnosed as HBsAg-positive during our study period; of which 67 (78.8) patients were <30 years of age while the remaining 18 (21.2) were >30 years of age. The mean gestational age at the time of admission was 37.6 ± 2.5 weeks of gestation. Women who were >30 years of age who are married for >5 years 10 (55.6) and those who are <30 years of age and married for 1–5 years 33 (49.3) were HBsAg-positive, p = 0.014b. It was noticed that gamma-glutamyl transferase was two times elevated in primigravida when compared to multigravida, which was statistically significant (p = 0.037). Meconium-stained liquor 3 (3.5) was the most common intraoperative finding seen in pregnant women who were HBsAg-positive. Conclusion: The development of chronic hepatitis B infection is inversely proportional to the age at which infection occurs. Close monitoring of liver function tests, particularly gamma-glutamyl transferase and antepartum fetal surveillance is important to increase the chance of good outcomes in these pregnancies. Key message: The better association of gamma-glutamyl transferase to obstetric score in HBsAg-positive pregnant women.


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  1. Borgia G, Carleo MA, Gaeta GB, et al. Hepatitis B in pregnancy. World J Gastroenterol 2012;18(34):4677. DOI: 10.3748/wjg.v18.i34.4677.
  2. Jonas MM. Hepatitis B and pregnancy: an underestimated issue. Liver Int 2009;29:133–139. DOI: 10.1111/j.1478-3231.2008.01933.x.
  3. Tran TT. Hepatitis B in pregnancy. Clin Infect Dis 2016;62(suppl_4): S314–S317.
  4. Yogeswaran K, Fung SK. Chronic hepatitis B in pregnancy: unique challenges and opportunities. Korean J Hepatol 2011;17(1):1. DOI: 10.3350/kjhep.2011.17.1.1.
  5. Abdi F, Novin MG, Afrakhteh M, et al. Hepatitis B and pregnancy: An update review article. World J Obstet Gynecol 2015;4(1):1–8. DOI: 10.5317/wjog.v4.i1.1.
  6. Aslam A, Campoverde Reyes KJ, Malladi VR, et al. Management of chronic hepatitis B during pregnancy. Gastroenterol Rep 2018;6(4): 257–262. DOI: 10.1093/gastro/goy025.
  7. Arevalo JA. Hepatitis B in pregnancy. Western J Med 1989;150(6):668. PMID: 2665319.
  8. Nguyen G, Garcia RT, Nguyen N, et al. Clinical course of hepatitis B virus infection during pregnancy. Aliment Pharmacol Ther 2009;29(7):755–764. DOI: 10.1111/j.1365-2036.2009.03932.x.
  9. Xiao B, Liu A, Zhang M, et al. Observation of the effect of the pregnancy complicated with the hepatitis B infection on the lying-in women and neonates. Saudi J Biol Sci 2019;26(8):1978–1981. DOI: 10.1016/j.sjbs.2019.08.020.
  10. Lao TT. Hepatitis B–chronic carrier status and pregnancy outcomes: an obstetric perspective. Best Pract Res Clin Obstet Gynaecol 2020;68:66–77. DOI: 10.1016/j.bpobgyn.2020.03.006.
  11. Kushner T, Sarkar M. Chronic hepatitis B in pregnancy. Clin Liver Dis 2018;12(1):24. DOI: 10.1002/cld.727.
  12. Chen ZX, Gu GF, Bian ZL, et al. Clinical course and perinatal transmission of chronic hepatitis B during pregnancy: a real-world prospective cohort study. J Infect 2017;75(2):146–154. DOI: 10.1016/j.jinf.2017.05.012.
  13. Ayoub WS, Cohen E. Hepatitis B management in the pregnant patient: an update. J Clin Transl Hepatol 2016;4(3):241–247. DOI: 10.14218/JCTH.2016.00014.
  14. Lamberth JR, Reddy SC, Pan JJ, et al. Chronic hepatitis B infection in pregnancy. World J Hepatol 2015;7(9):1233. DOI: 10.4254/wjh.v7.i9.1233.
  15. Cai Q, Liu H, Han W, et al. Maternal HBsAg carriers and adverse pregnancy outcomes: a hospital-based prospective cohort analysis. J Viral Hepat 2019;26(8):1011–1018. DOI: 10.1111/jvh.13105.
  16. Gerety RJ, Schweitzer IL. Viral hepatitis type B during pregnancy, the neonatal period, and infancy. J Pediatr 1977;90(3):368–374. DOI: 10.1016/s0022-3476(77)80695-1.
  17. Tan HH, Lui HF, Chow WC. Chronic hepatitis B virus (HBV) infection in pregnancy. Hepatol Int 2008;2(3):370–375. DOI: 10.1007/s12072-008-9063-4.
  18. Sirilert S, Traisrisilp K, Sirivatanapa P, et al. Pregnancy outcomes among chronic carriers of hepatitis B virus. Int J Gynecol Obstet 2014;126(2):106–110. DOI: 10.1016/j.ijgo.2014.02.019.
  19. Wu K, Wang H, Li S, et al. Maternal hepatitis B infection status and adverse pregnancy outcomes: a retrospective cohort analysis. Arch Gynecol Obstet 2020;302(3):595–602. DOI: 10.1007/s00404-020-05630-2.
  20. Arfaoui D, Fkih M, Hafsa AE, et al. Hépatite virale B et grossesse [Hepatitis B and pregnancy]. Tunis Med 2010;88(6):383–389 [French] PMID: 20517846.
  21. Pol S, Corouge M, Fontaine H. Hepatitis B virus infection and pregnancy. Clin Res Hepatol Gastroenterol 2011;35(10):618–622. DOI: 10.1016/j.clinre.2011.03.013.
  22. Park JS, Pan C. Current recommendations of managing HBV infection in preconception or pregnancy. Front Med 2014;8(2):158–165. DOI: 10.1007/s11684-014-0340-4.
  23. Shiraki K, Yoshihara N, Kawana T, et al. Hepatitis B surface antigen and chronic hepatitis in infants born to asymptomatic carrier mothers. Am J Dis Child 1977;131(6):644–647. DOI: 10.1001/archpedi.1977.02120190038007.
  24. Boland GJ, Veldhuijzen IK, Janssen HL, et al. Beleid en behandeling bij zwangeren met hepatitis B [Management and treatment of pregnant women with hepatitis B]. Ned Tijdschr Geneeskd 2009;153:A905 [Dutch]. PMID: 20051170.
  25. Kebede KM, Abateneh DD, Belay AS. Hepatitis B virus infection among pregnant women in Ethiopia: a systematic review and meta-analysis of prevalence studies. BMC Infect Dis 2018;18(1):322. DOI: 10.1186/s12879-018-3234-2.
  26. Garg R, Nigam A, Singh S, et al. Seroprevalence of hepatitis B surface antigen among pregnant women in a tertiary care health center of North India. J South Asian Feder Obst Gynae 2017;9(2):164–168. DOI: 10.5005/jp-journals-10006-1484.
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