Maternal Hepatitis B Infection Burden, Comorbidity and Pregnancy Outcome in a Low-Income Population on the Myanmar-Thailand Border: A Retrospective Cohort Study

被引:19
作者
Bierhoff, Marieke [1 ,2 ]
Angkurawaranon, Chaisiri [3 ]
Min, Aung Myat [1 ]
Gilder, Mary Ellen [1 ]
Tun, Nay Win [1 ]
Keereevijitt, Arunrot [1 ]
Win, Aye Kyi [1 ]
Win, Elsi [1 ]
Carrara, Verena Ilona [1 ,4 ,5 ]
Brummaier, Tobias [1 ,4 ,5 ]
Chu, Cindy S. [1 ]
Thielemans, Laurence [1 ,6 ]
Sriprawat, Kanlaya [1 ]
Hanboonkunupakarn, Borimas [7 ]
Rijken, Marcus [8 ,9 ]
Nosten, Francois [1 ,10 ]
van Vugt, Michele [2 ]
McGready, Rose [1 ,10 ]
机构
[1] Mahidol Univ, Shoklo Malaria Res Unit, Mahidol Oxford Trop Med Res Unit, Mae Sot 63110, Thailand
[2] Univ Amsterdam, Acad Ctr, Div Infect Dis, Amsterdam, Netherlands
[3] Chiang Mai Univ, Dept Family Med, Fac Med, Chiang Mai 50200, Thailand
[4] Swiss Trop & Publ Hlth Inst, Dept Med, Basel, Switzerland
[5] Univ Basel, Fac Med, Basel, Switzerland
[6] Univ Libre Bruxelles, Hosp Erasme, Clin Univ Bruxelles, Neonatol Pediat, Brussels, Belgium
[7] Mahidol Univ, Mahidol Oxford Trop Med Res Unit, Bangkok 10400, Thailand
[8] Univ Utrecht, Med Ctr, Utrecht, Netherlands
[9] Julius Ctr Global Hlth, NL-3584 CX Utrecht, Netherlands
[10] Univ Oxford, Ctr Trop Med & Global Hlth, Nuffield Dept Med Res Bldg, Oxford OX3 7FZ, England
关键词
VIRUS INFECTION; PLASMODIUM-FALCIPARUM; CESAREAN-SECTION; RISK-FACTORS; TRANSMISSION; SEROPREVALENCE; WOMEN; IMMUNIZATION; ELIMINATION; MALARIA;
D O I
10.1155/2019/8435019
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objectives. Hepatitis B virus (HBV) was believed to have minimal impact on pregnancy outcomes apart from the risk of perinatal transmission. In more recent years, there have been reports of adverse associations, most consistently preterm birth (PTB), but this is in the context of high rates of caesarean section. The aim of this study was to explore the association of HBV on pregnancy outcomes in marginalized, low-income populations on the Myanmar-Thailand border. Methods. HBsAg positive (+) point of care rapid detection tests results were confirmed by immunoassays. Women with a confirmed HBsAg status, HIV- and syphilis-negative at first antenatal care screening, singleton fetus and known pregnancy outcome (Aug-2012 to Dec-2016) were included. Logistic regression analysis was used to evaluate associations between HBV group (controls HBsAg negative, HBsAg+/HBeAg-, or HBsAg+/HBeAg+) and pregnancy outcome and comorbidity. Results. Most women were tested, 15,046/15,114 (99.6%) for HBV. The inclusion criteria were not met for 4,089/15,046 (27.2%) women due mainly to unavailability of pregnancy outcome and nonconfirmation of HBsAg+. In evaluable women 687/11,025 (6.2%) were HBsAg+, with 476/11,025 (4.3%) HBsAg+/HBeAg- and 211/11,025 (1.9%) were HBsAg+/HBeAg+. The caesarean section rate was low at 522/8,963 (5.8%). No significant associations were observed between pregnancy comorbidities or adverse pregnancy outcomes and HBV status. Conclusions. The results highlight the disease burden of HBV in women on the Myanmar-Thailand border and support original reports of a lack of significant associations with HBsAg+ irrespective of HBeAg status, for comorbidity, and pregnancy outcomes in deliveries supervised by skilled birth attendants.
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页数:11
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