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Influence of different delivery modes and HBV DNA titers on mother-to-child transmission of hepatitis B - 14/10/20

Doi : 10.1016/j.clinre.2020.08.017 
Tye Kian Deng a, 1, Ping Yang b, 1, Xiaoyi Liu c, Dongju Wang b, Huijuan Luo b, Juan Zhou b, Xiaomin Xiao b,
a Department of Obstetrics and Gynecology, The Fifth Affiliated Hospital of Guangzhou Medical University, China 
b Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou, China 
c Department of Neonatology, The First Affiliated Hospital of Jinan University, Guangzhou, China 

Corresponding author.
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 14 October 2020

Highlights

The risk of HBV maternal-to-infant vertical transmission increases with the HBV DNA titer of pregnant women.
The delivery mode may influence the risk of HBV maternal-to-infant vertical transmission for HBV-carrier pregnant women with HBV DNA107 copies/ml.
Elective cesarean section may reduce the HBV maternal-to-infant vertical transmission.
Pregnant women who are HBeAg-positive with HBV DNA106 copies/ml should be targeted for the prevention of maternal-to-infant vertical transmission.

Le texte complet de cet article est disponible en PDF.

Abstract

Background

The influence of different delivery modes on the mother-to-child transmission (MTCT) rate of pregnant women with high hepatitis B viremia was investigated.

Methods

A retrospective analysis was performed on data for 855 hepatitis- B -virus (HBV) carrier mothers who received regular prenatal care and delivered at the First Affiliated Hospital of Jinan University from January 2011 to October 2015. The neonates were classified into three groups according to the delivery mode: eutocia (438 cases), Non-parturient cesarean delivery (371 cases), and parturient cesarean delivery (46 cases). The neonatal HBV surface antigen (HBsAg) positive rates of the three delivery groups were comparatively analyzed to determine the influence of the delivery mode on HBV MTCT. Of the 855 HBV-carrier mothers, 480 mothers and respective newborns were tested for HBV-DNA and classified into four groups: HBV DNA≥107 copies/mL (96 cases), 105≤HBV DNA<107 copies/mL (37 cases), 103≤HBV DNA<105 copies/mL (85 cases), and HBV DNA<103 copies/mL (262 cases). The effect of the HBV DNA titers of these pregnant women on HBV MTCT was analyzed.

Results

Statistically significant (P<0.05) differences were found among the HBsAg positive rates of neonates of HBV-carrier pregnant women delivered by the three methods from HBV-carrier pregnant women with HBV DNA≥107 copies/mL. No statistically significant (P>0.05) differences among the HBsAg positive rates were found for neonates delivered by the three methods from HBV-carrier pregnant women with HBV DNA<107 copies/mL.

Conclusions

The delivery mode may influence the risk of HBV maternal-to-infant vertical transmission for HBV-carrier pregnant women with HBV DNA≥107 copies/mL. That is, elective cesarean section may reduce the HBV maternal-to-infant vertical transmission.

Le texte complet de cet article est disponible en PDF.

Abbreviations : MTCT, HBV, HBsAg, HBeAg, HBIg, HIV, HBsAb, HBeAb, HBcAb, HCV, CMV, HSV

Keywords : Hepatitis B virus, HBV DNA, pregnancy, Neonate, Maternal-to-infant vertical transmission, Delivery mode


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