Peer-reviewed article
Factors associated with adverse perinatal outcomes among HBsAg-positive pregnant women in China: a retrospective cohort study.
Meng Zhang, Huimin Qu, Yuan Cao, Cannan Shi, Junjian He et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined adverse birth outcomes in 53,150 pregnant women with hepatitis B infection in China. Preterm birth occurred in 5.63% of cases, low birth weight in 3.16%, and small-for-gestational-age in 5.16%. Higher maternal education and multiparity were protective factors, while high viral load and lower education levels increased risk. The findings suggest targeted prenatal monitoring and health education could reduce adverse outcomes.
Key points
- Preterm birth incidence was 5.63%, low birth weight 3.16%, and small-for-gestational-age 5.16% among HBsAg-positive pregnant women
- Higher maternal education was protective against all three adverse outcomes
- High HBV viral load (≥2 × 10^5 copies/mL) and HBeAg positivity were risk factors for small-for-gestational-age
- Multiparity (gravidity >1 and parity >1) was protective against small-for-gestational-age but gravidity >1 increased preterm birth risk
- Antiviral therapy during pregnancy was associated with increased small-for-gestational-age risk
Limitations
This is a descriptive observational study based on retrospective administrative data that identifies associations but cannot establish causation. The reasons for the unexpected association between antiviral therapy and adverse outcomes are not explored, limiting interpretation of this finding.
Abstract
BACKGROUND: This study aimed to investigate the incidence of and explore risk factors for preterm birth (PB), low birth weight (LBW), and small for gestational age (SGA) among hepatitis B surface antigen (HBsAg)-positive pregnant women. METHODS: This study conducted a retrospective analysis of data from 53,150 HBsAg-positive pregnant women reported in the Henan's information system for the management of mother-to-child transmission prevention of HBV between January 2021 and February 2022. Chi-square analysis, multivariate logistic regression analysis, and a Chi-square automatic interaction detector (CHAID) decision tree model were employed to investigate factors. RESULTS: The incidence rates of PB, LBW, and SGA were 5.63%, 3.16%, and 5.16%, respectively. Multivariate logistic regression analysis revealed that maternal age of 20-30 years, a higher education level, and a female infants were protective factors against PB, whereas floating population and a gravidity greater than 1 were risk factors. For LBW, a higher education level was protective, while a female infant was a risk factor. Regrading SGA, higher education levels, gravidity > 1, parity > 1 were identified as protective factors, whereas HBV DNA ≥2 × 105 or HBeAg positive and antiviral therapy were risk factors. The CHAID model identified the sets of factors associated with each outcome. CONCLUSION: This study found that the key modifiable risk factors included high viral load and lower education levels, while higher education and multiparity were protective. These findings support implementing targeted interventions such as enhanced prenatal monitoring for women with high viral load and health education programs for specific groups to mitigate adverse perinatal outcomes.