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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 8
Aug.  2022
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Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(8): 1763-1767

Influence of intrahepatic cholestasis of pregnancy on adverse pregnancy outcomes of HBV-infected pregnant women

DOI: 10.3969/j.issn.1001-5256.2022.08.009
  • a.

    Department of Obstetrics, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China

  • b.

    Intractable Hepatic Diseases and Artificial Liver Treatment & Training Center, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China

Research funding:

National Science and Technology Key Project on "Major Infectious Diseases such as HIV/AIDS, Viral Hepatitis Prevention and Treatment" (2017ZX10201201-001-001);

National Science and Technology Key Project on "Major Infectious Diseases such as HIV/AIDS, Viral Hepatitis Prevention and Treatment" (2017ZX10201201-002-002);

National Science and Technology Key Project on "Major Infectious Diseases such as HIV/AIDS, Viral Hepatitis Prevention and Treatment" (2017ZX10201201-002-009);

Beijing Municipal Hospital Scientific Research and Cultivation Program (PX2020067)

More Information
  • Corresponding author: DUAN Zhongping, duan@ccmu.edu.cn(ORCID: 0000-0002-5927-5979)
  • Received Date: 2022-05-13
  • Accepted Date: 2022-06-16
  • Published Date: 2022-08-20
    Abstract
  •   Objective  To investigate the influence of intrahepatic cholestasis of pregnancy (ICP) on adverse pregnancy outcomes of hepatitis B virus (HBV)-infected pregnant women.  Methods  A retrospective analysis was performed for 232 pregnant women with chronic HBV infection who were admitted to Beijing YouAn Hospital, Capital Medical University, from March 2018 to March 2021. According to the presence or absence of ICP, the patients were divided into HBV infection group with 100 patients and HBV+ICP group with 132 patients; according to the severity of ICP, the patients in the HBV+ICP group were further divided into HBV+mild ICP group with 86 patients and HBV+severe ICP group with 46 patients. The above groups were compared in terms of the incidence rates of maternal complications during pregnancy, such as premature delivery, premature rupture of membranes, gestational diabetes mellitus, hypertensive disorder complicating pregnancy, and postpartum hemorrhage (PPH), as well as the adverse outcomes of fetus/neonate, such as intrauterine fetal death, neonatal asphyxia, amniotic fluid pollution degree Ⅲ(AFⅢ), neonatal respiratory distress syndrome, small-for-gestational-age (SGA), admission to the neonatal intensive care unit, pneumonia, and mother-to-child transmission (MTCT) of HBV. A one-way analysis of variance was used for comparison between multiple groups; the chi-square test, the chi-square test with continuity correction or the Fisher's exact test was used for comparison of categorical data between multiple groups.  Results  Compared with the HBV infection group in terms of maternal complications in late pregnancy, the HBV+ICP group had significantly higher incidence rates of premature delivery and PPH (χ2=4.169 and 5.448, P=0.041 and 0.020), and in terms of the adverse outcomes of neonates, the HBV+ICP group had significantly higher incidence rates of neonatal asphyxia, AFⅢ, and SGA than the HBV infection group (χ2=5.448, 16.567, and 11.053, P=0.020, P < 0.001, and P=0.002). In terms of the adverse outcomes of neonates, the HBV+severe ICP group had significantly higher incidence rates of AFⅢ and SGA than the HBV+mild ICP group (χ2=4.200 and 4.511, P=0.040 and 0.034).  Conclusion  Compared with the pregnant women with HBV infection alone, the pregnant women with HBV infection and ICP have significantly higher incidence rates of adverse pregnancy outcomes in mothers and neonates, and the incidence rate of adverse outcomes in neonates increases with the increase in the severity of ICP. However, ICP has no influence on HBV MTCT.

     

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    • References(23)
  • [1]
    Obstetrics Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Association. Guidelines for the management of intrahepatic cholestasis of pregnancy (2015)[J]. J Clin Hepatol, 2015, 31(10): 1575-1578. DOI: 10.3969/j.issn.1001-5256.2015.10.003.

    中华医学会妇产科学分会产科学组. 妊娠期肝内胆汁淤积症诊疗指南(2015)[J]. 临床肝胆病杂志, 2015, 31(10): 1575-1578. DOI: 10.3969/j.issn.1001-5256.2015.10.003.
    [2]
    XIN X, WANG Y, CHENG J, et al. Seroepidemiological survey of hepatitis B virus infection among 764, 460 women of childbearing age in rural China: A cross-sectional study[J]. J Clin Virol, 2016, 81: 47-52. DOI: 10.1016/j.jcv.2016.05.014.
    [3]
    KUNTZ M, KUNTZ HD. Hepatology textbook and atlas[M]. Berlin, Heidelberg: Springer, 2008.
    [4]
    CHEN YC, ZHANG YM, ZHANG HS, et al. Effects of viral load of HBV-infected pregnant women on the humoral immune status and neonatal HBV infection rate[J]. Int J Virol, 2022, 29(1): 49-53. DOI: 10.3760/cma.j.issn.1673-4092.2022.01.010.

    陈月婵, 张艳敏, 张红升, 等. HBV感染孕妇病毒载量对体液免疫状态及新生儿HBV感染率的影响[J]. 国际病毒学杂志, 2022, 29(1): 49-53. DOI: 10.3760/cma.j.issn.1673-4092.2022.01.010.
    [5]
    CHEN Y, TIAN Z. HBV-induced immune imbalance in the development of HCC[J]. Front Immunol, 2019, 10: 2048. DOI: 10.3389/fimmu.2019.02048.
    [6]
    Chinese Society of Infectious Diseases, Chinese Medical Association, Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B (version 2019)[J]. J Clin Hepatol, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.

    中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.
    [7]
    SHEN JC, LENG XJ, ZHANG Y, et al. Interpretation of managing HBV in pregnancy. Prevention, prophylaxis, treatment and follow-up[J]. J Clin Hepatol, 2016, 32(6): 1060-1068. DOI: 10.3969/j.issn.1001-5256.2016.06.008.

    申姣春, 冷雪君, 张莹, 等. 《妊娠期HBV的阻断、预防、治疗和随访管理》解读[J]. 临床肝胆病杂志, 2016, 32(6): 1060-1068. DOI: 10.3969/j.issn.1001-5256.2016.06.008.
    [8]
    PIECHOTA J, JELSKI W. Intrahepatic cholestasis in pregnancy: Review of the literature[J]. J Clin Med, 2020, 9(5): 1361. DOI: 10.3390/jcm9051361.
    [9]
    LIU Y, MA C, JIA H, et al. Knowledge, attitudes, and practices regarding hepatitis B vaccination among hospital-based doctors and nurses in China: Results of a multi-site survey[J]. Vaccine, 2018, 36(17): 2307-2313. DOI: 10.1016/j.vaccine.2018.03.018.
    [10]
    YULE CS, HOLCOMB DS, KRAUS AC, et al. Cholestasis: A prospective study of perinatal outcomes and time to symptom improvement[J]. Am J Perinatol, 2021, 38(5): 414-420. DOI: 10.1055/s-0040-1717076.
    [11]
    GERMAIN AM, KATO S, CARVAJAL JA, et al. Bile acids increase response and expression of human myometrial oxytocin receptor[J]. Am J Obstet Gynecol, 2003, 189(2): 577-582. DOI: 10.1067/s0002-9378(03)00545-3.
    [12]
    KONDRACKIENE J, KUPCINSKAS L. Intrahepatic cholestasis of pregnancy-current achievements and unsolved problems[J]. World J Gastroenterol, 2008, 14(38): 5781-5788. DOI: 10.3748/wjg.14.5781.
    [13]
    ARTHUIS C, DIGUISTO C, LORPHELIN H, et al. Perinatal outcomes of intrahepatic cholestasis during pregnancy: An 8-year case-control study[J]. PLoS One, 2020, 15(2): e0228213. DOI: 10.1371/journal.pone.0228213.
    [14]
    WU K, WANG H, LI S, et al. Maternal hepatitis B infection status and adverse pregnancy outcomes: a retrospective cohort analysis[J]. Arch Gynecol Obstet, 2020, 302(3): 595-602. DOI: 10.1007/s00404-020-05630-2.
    [15]
    ROY A, PREMKUMAR M, MISHRA S, et al. Role of ursodeoxycholic acid on maternal serum bile acids and perinatal outcomes in intrahepatic cholestasis of pregnancy[J]. Eur J Gastroenterol Hepatol, 2021, 33(4): 571-576. DOI: 10.1097/MEG.0000000000001954.
    [16]
    ZHANG C, WEI H, ZHU YX. Adverse pregnancy outcomes and mother-to-child transmission in patients with hepatitis B virus infection and intrahepatic cholestasis of pregnancy[J]. Ginekol Pol, 2021. DOI: 10.5603/GP.a2021.0110. [Online ahead of print]
    [17]
    ABU-HAYYEH S, PAPACLEOVOULOU G, LÖVGREN-SANDBLOM A, et al. Intrahepatic cholestasis of pregnancy levels of sulfated progesterone metabolites inhibit farnesoid X receptor resulting in a cholestatic phenotype[J]. Hepatology, 2013, 57(2): 716-726. DOI: 10.1002/hep.26055.
    [18]
    BATSRY L, ZLOTO K, KALTER A, et al. Perinatal outcomes of intrahepatic cholestasis of pregnancy in twin versus singleton pregnancies: is plurality associated with adverse outcomes?[J]. Arch Gynecol Obstet, 2019, 300(4): 881-887. DOI: 10.1007/s00404-019-05247-0.
    [19]
    LEE RH, KWOK KM, INGLES S, et al. Pregnancy outcomes during an era of aggressive management for intrahepatic cholestasis of pregnancy[J]. Am J Perinatol, 2008, 25(6): 341-345. DOI: 10.1055/s-2008-1078756.
    [20]
    ROOK M, VARGAS J, CAUGHEY A, et al. Fetal outcomes in pregnancies complicated by intrahepatic cholestasis of pregnancy in a Northern California cohort[J]. PLoS One, 2012, 7(3): e28343. DOI: 10.1371/journal.pone.0028343.
    [21]
    KREMER AE, WOLF K, STÄNDER S. Intrahepatic cholestasis of pregnancy: Rare but important[J]. Hautarzt, 2017, 68(2): 95-102. DOI: 10.1007/s00105-016-3923-y.
    [22]
    ZECCA E, de LUCA D, BARONI S, et al. Bile acid-induced lung injury in newborn infants: a bronchoalveolar lavage fluid study[J]. Pediatrics, 2008, 121(1): e146-e149. DOI: 10.1542/peds.2007-1220.
    [23]
    FUNK AL, LU Y, YOSHIDA K, et al. Efficacy and safety of antiviral prophylaxis during pregnancy to prevent mother-to-child transmission of hepatitis B virus: a systematic review and meta-analysis[J]. Lancet Infect Dis, 2021, 21(1): 70-84. DOI: 10.1016/S1473-3099(20)30586-7.
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