Abstract
Giriş: B hepatiti dünya çapında en sık görülen enfeksiyöz hastalıklardandır. Viral bulaşın önemli bir kısmı anneden bebeğe geçiş şeklinde olmaktadır. Bazı çalışmalarda maternal-fetal bulaş dışında gebelikte gestasyonel diyabet (GDM), gebeliğin hipertansif hastalıkları, preterm doğum ve haftasına göre düşük doğum ağırlığı (DDA) gibi olumsuz gebelik sonuçları daha sık gözlenmiştir.
Amaç: Gebelikte Hepatit B taşıyıcılığının maternal veya fetal kötü obstetrik sonuçları (gestasyonel diyabet, gebeliğin hipertansif hastalıkları, preterm doğum, düşük doğum ağırlığı, gebelik kolestazı) arttırması ile ilgili yapılan çalışmalarda literatürde görüş birliği bulunmamaktadır. Biz bu çalışmada hepatit B taşıyıcılığının gebelik ve perinatal sonuçlar üzerine etkisini araştırmayı planladık
Gereç ve Yöntem: Bu retrospektif kohort araştırmaya çalışma grubu olarak Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı Hastalıkları Eğitim ve Araştırma Hastanesi Kadın Doğum Kliniği’nde 2009-2019 yılları arasında takipleri yapılan ve sonrasında doğumları gerçekleşen hepatit B taşıyıcısı gebeler dahil edildi. Gestasyonel diyabet, gebeliğin hipertansif hastalıkları, preterm doğum, düşük doğum ağırlığı, gebelik kolestazı riski hepatit B negatif olan kontrol grubu ile karşılaştırldı.
Bulgular: Çalışmamıza 237 HBsAg pozitf , 260 kontrol olmak üzere 497 hasta dahil edildi. Kontrol grubu ile çalışma grubu arasında demografik karakterlerden yaş, gravida, parite ve VKİ açısından istatistiksel fark saptanmadı. Her iki grupta obstetrik ve perinatal sonuçlar arasında istatistiksel fark tespit edilemedi
Sonuç: Hepatit B taşıyıcısı gebelerde kötü obstetrik sonuçlarda artış tespit edilmemiştir; ancak bu konuda daha büyük randomize prospektif çalışmalara ihtiyaç duyulmaktadır.
Keywords
References
- 1. Sarri G, Westby M, Bermingham S, Hill-Cawthorne G, Thomas H, Group GD. Diagnosis and management of chronic hepatitis B in children, young people, and adults: summary of NICE guidance. BMJ. 2013;346:f3893.
- 2. Özkan H. Epidemiology of Chronic Hepatitis B in Turkey. Euroasian J Hepatogastroenterol. 2018;8(1):73-4.
- 3. Schillie S, Vellozzi C, Reingold A, Harris A, Haber P, Ward JW, et al. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2018;67(1):1-31.
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- 5. Lao TT, Chung MK, Cheung TK, Law LW. Antenatal hepatitis B and increased risk of gestational diabetes mellitus--Implications for obstetric care. J Infect. 2016;72(5):625-6.
- 6. Wan Z, Zhou A, Zhu H, Lin X, Hu D, Peng S, et al. Maternal Hepatitis B Virus Infection and Pregnancy Outcomes: A Hospital-based Case-control Study in Wuhan, China. J Clin Gastroenterol. 2018;52(1):73-8.
- 7. Sirilert S, Traisrisilp K, Sirivatanapa P, Tongsong T. Pregnancy outcomes among chronic carriers of hepatitis B virus. Int J Gynaecol Obstet. 2014;126(2):106-10.
- 8. Connell LE, Salihu HM, Salemi JL, August EM, Weldeselasse H, Mbah AK. Maternal hepatitis B and hepatitis C carrier status and perinatal outcomes. Liver Int. 2011;31(8):1163-70.
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- 25. Cui AM, Cheng XY, Shao JG, Li HB, Wang XL, Shen Y, et al. Maternal hepatitis B virus carrier status and pregnancy outcomes: a prospective cohort study. BMC Pregnancy Childbirth. 2016;16:87.
- 26. Peng S, Wan Z, Lin X, Li X, Du Y. Maternal hepatitis B surface antigen carrier status increased the incidence of gestational diabetes mellitus. BMC Infect Dis. 2019;19(1):147.
- 27. Zhao Y, Chen YL, Song HQ, Huang PY, Wang LY, Liu W, et al. Effects of maternal hepatitis B surface antigen positive status on the pregnancy outcomes: A retrospective study in Xiamen, China, 2011-2018. PLoS One. 2020;15(3):e0229732.
- 28. Yue DK, Molyneaux LM, Ross GP, Constantino MI, Child AG, Turtle JR. Why does ethnicity affect prevalence of gestational diabetes? The underwater volcano theory. Diabet Med. 1996;13(8):748-52.
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Abstract
Introduction: B hepatitis is one of the most common infectious diseases worldwide. An important part of viral transmission occurs from mother to baby. In some studies, other than maternal-fetal transmission, adverse pregnancy outcomes such as gestational diabetes (GDM), hypertensive diseases of pregnancy, preterm birth and low birth weight (LBW) were observed more frequently.
Aim: There is no consensus in the literature whether there is a relationship between adverse obstetric outcomes including gestational diabetes, hypertensive diseases of pregnancy, preterm birth, low birth weight, obstetric cholestasis and hepatitis B carriage during pregnancy . In this study, we planned to investigate the effect of hepatitis B carriage on pregnancy and perinatal outcomes
Material-method: This retrospective cohort study was conducted in Dr. Sami Ulus Obstetrics and Gynecology, Pediatric Health and Disease Training and Research Hospital. Hepatitis B antigen positive pregnant women who gave birth in our hospital between years of 2009-2019 were included in our study. The risk of gestational diabetes, hypertensive diseases of pregnancy, preterm birth, low birth weight, obstetric cholestasis was compared with the hepatitis B negative pregnant women as control group.
Results: Our study included 497 patients, 237 HBsAg positive pregnants and 260 healthy controls. There was no statistical difference between the control group and the study group in terms of demographic characters, age, gravida, parity and BMI. There was no statistical difference between obstetric and perinatal outcomes in both groups
Conclusion: Hepatitis B carriage during pregnancy is not associated with adverse obstetric outcomes. However, larger randomized prospective studies are needed on this subject.
Keywords
References
- 1. Sarri G, Westby M, Bermingham S, Hill-Cawthorne G, Thomas H, Group GD. Diagnosis and management of chronic hepatitis B in children, young people, and adults: summary of NICE guidance. BMJ. 2013;346:f3893.
- 2. Özkan H. Epidemiology of Chronic Hepatitis B in Turkey. Euroasian J Hepatogastroenterol. 2018;8(1):73-4.
- 3. Schillie S, Vellozzi C, Reingold A, Harris A, Haber P, Ward JW, et al. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2018;67(1):1-31.
- 4. CDC. Recommendation of the Immunization Practices Advisory Committee (ACIP). Inactivated hepatitis B virus vaccine. MMWR Morb Mortal Wkly Rep. 1982;31(24):317-22, 27-8.
- 5. Lao TT, Chung MK, Cheung TK, Law LW. Antenatal hepatitis B and increased risk of gestational diabetes mellitus--Implications for obstetric care. J Infect. 2016;72(5):625-6.
- 6. Wan Z, Zhou A, Zhu H, Lin X, Hu D, Peng S, et al. Maternal Hepatitis B Virus Infection and Pregnancy Outcomes: A Hospital-based Case-control Study in Wuhan, China. J Clin Gastroenterol. 2018;52(1):73-8.
- 7. Sirilert S, Traisrisilp K, Sirivatanapa P, Tongsong T. Pregnancy outcomes among chronic carriers of hepatitis B virus. Int J Gynaecol Obstet. 2014;126(2):106-10.
- 8. Connell LE, Salihu HM, Salemi JL, August EM, Weldeselasse H, Mbah AK. Maternal hepatitis B and hepatitis C carrier status and perinatal outcomes. Liver Int. 2011;31(8):1163-70.
- 9. To WW, Cheung W, Mok KM. Hepatitis B surface antigen carrier status and its correlation to gestational hypertension. Aust N Z J Obstet Gynaecol. 2003;43(2):119-22.
- 10. Lao TT, Sahota DS, Cheng YK, Law LW, Leung TY. Maternal hepatitis B surface antigen status and incidence of pre-eclampsia. J Viral Hepat. 2013;20(5):343-9.
- 11. Tse KY, Ho LF, Lao T. The impact of maternal HBsAg carrier status on pregnancy outcomes: a case-control study. J Hepatol. 2005;43(5):771-5.
- 12. Bulletins—Obstetrics CoP. ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstet Gynecol. 2018;131(2):e49-e64.
- 13. Association AD. 2. Classification and Diagnosis of Diabetes:. Diabetes Care. 2020;43(Suppl 1):S14-S31.
- 14. Bulletins—Obstetrics ACoOaGCoP. Practice Bulletin No. 171: Management of Preterm Labor. Obstet Gynecol. 2016;128(4):e155-64.
- 15. ACOG Practice Bulletin No. 202: Gestational Hypertension and Preeclampsia. Obstet Gynecol. 2019;133(1):e1-e25.
- 16. Bicocca MJ, Sperling JD, Chauhan SP. Intrahepatic cholestasis of pregnancy: Review of six national and regional guidelines. Eur J Obstet Gynecol Reprod Biol. 2018;231:180-7.
- 17. ACOG Practice Bulletin No. 204: Fetal Growth Restriction. Obstet Gynecol. 2019;133(2):e97-e109.
- 18. Gynecologists ACoOa. ACOG Practice Bulletin No. 86: Viral hepatitis in pregnancy. Obstet Gynecol. 2007;110(4):941-56.
- 19. Ma X, Sun D, Li C, Ying J, Yan Y. Chronic hepatitis B virus infection and preterm labor(birth) in pregnant women-an updated systematic review and meta-analysis. J Med Virol. 2018;90(1):93-100.
- 20. Cui AM, Shao JG, Li HB, Shen Y, Chen ZX, Zhang S, et al. Association of chronic hepatitis B virus infection with preterm birth: our experience and meta-analysis. J Perinat Med. 2017;45(8):933-40.
- 21. Saleh Gargari S, Hantoushzadeh h S, Zendehdel N, Jamal A, Aghdam H. The Association of Maternal HBsAg Carrier Status and Perinatal Outcome. Hepatitis Monthly. 2009;9:180-4.
- 22. Bajema KL, Stankiewicz Karita HC, Tenforde MW, Hawes SE, Heffron R. Maternal Hepatitis B Infection and Pregnancy Outcomes in the United States: A Population-Based Cohort Study. Open Forum Infect Dis. 2018;5(6):ofy134.
- 23. Tan J, Liu X, Mao X, Yu J, Chen M, Li Y, et al. HBsAg positivity during pregnancy and adverse maternal outcomes: a retrospective cohort analysis. J Viral Hepat. 2016;23(10):812-9.
- 24. Cai Q, Liu H, Han W, Liu L, Xu Y, He Y, et al. Maternal HBsAg carriers and adverse pregnancy outcomes: A hospital-based prospective cohort analysis. J Viral Hepat. 2019;26(8):1011-8.
- 25. Cui AM, Cheng XY, Shao JG, Li HB, Wang XL, Shen Y, et al. Maternal hepatitis B virus carrier status and pregnancy outcomes: a prospective cohort study. BMC Pregnancy Childbirth. 2016;16:87.
- 26. Peng S, Wan Z, Lin X, Li X, Du Y. Maternal hepatitis B surface antigen carrier status increased the incidence of gestational diabetes mellitus. BMC Infect Dis. 2019;19(1):147.
- 27. Zhao Y, Chen YL, Song HQ, Huang PY, Wang LY, Liu W, et al. Effects of maternal hepatitis B surface antigen positive status on the pregnancy outcomes: A retrospective study in Xiamen, China, 2011-2018. PLoS One. 2020;15(3):e0229732.
- 28. Yue DK, Molyneaux LM, Ross GP, Constantino MI, Child AG, Turtle JR. Why does ethnicity affect prevalence of gestational diabetes? The underwater volcano theory. Diabet Med. 1996;13(8):748-52.
- 29. Lobstein S, Faber R, Tillmann HL. Prevalence of hepatitis B among pregnant women and its impact on pregnancy and newborn complications at a tertiary hospital in the eastern part of Germany. Digestion. 2011;83(1-2):76-82.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | April 1, 2021 |
| Submission Date | October 22, 2020 |
| Acceptance Date | November 17, 2020 |
| Published in Issue | Year 2021 Volume: 18 Issue: 1 |
