妊娠合并隐匿性或显性乙型肝炎病毒(HBV)感染对早产发生率的影响

The impact of occult or overt hepatitis B virus(HBV)infection during pregnancy on the incidence of preterm birth

目的探讨妊娠合并隐匿性或显性乙型肝炎病毒(hepatitis B virus,HBV)感染对早产发生率的影响。方法采用前瞻性队列研究设计,以2012年6月1日至2013年3月15日间安庆市立医院所有住院分娩的孕妇为研究对象,纳入妊娠结局为单胎活产的孕妇,收集其血清并进行HBV表面抗原和HBV S基因片段的检测,并通过医院电子病历系统收集孕妇人口学信息等资料,采用单因素和多因素统计方法分析妊娠合并隐匿性和显性HBV感染对早产发生率的影响。结果孕妇早产发生率为21.00%(189/900);其中隐匿性HBV感染组、显性HBV感染组和非HBV感染组孕妇在人口学特征方面相似可比,其早产发生率分别为20.51%(16/78)、20.00%(14/70)、21.14%(159/752)。单因素与多因素分析未发现早产发生率与HBV感染相关,以非HBV感染组为参照,多因素COX回归分析发现显性HBV感染、隐匿性HBV感染与早产间调整后相对危险度(adjusted risk ratio,RRa)分别为1.03(0.81,1.32)和0.99(0.78,1.25);以同样参照,多因素线性回归分析发现孕周与HBV感染状况的回归系数β为0.09(-0.14,0.31)。结论妊娠合并隐匿性或显性HBV感染与早产的发生率无明显相关。

Objective To examine the impact of occult or overt hepatitis B virus（HBV） infection during pregnancy on the incidence of preterm birth. Methods We prospectively enrolled singleton pregnant women with alive newborns from June I st, 2012 to March I5, 2013 in Anqing City Hospital.Serum samples were collected and tested with HBV surface antigen and S gene segment. Demographic information was collected from hospital electronic medical records system. Then single variate and multivariate analysis were used to compare the incidence of preterm birth by the status of infection with HBV. Results The proportion of preterm birth rate was 2l.00%（189/900） overall and it was 20.51% （16/78） ,20.00% （14/70） and 21.14% （159/752） respectively among pregnant women with occult HBV infection （OBI）, those with overt HBV infection and those non-HBV controls, whose demographic characteristics were roughly comparable. The single and muhivariate analysis did not find that the incidence of preterm birth was significantly associated with the status of infection with HBV. Based on the Non-HBV group, the mutivariate analysis of COX regression found that the adjusted relative ratio （RRa） was 1.03 （0.81,1.32） for the overt HBV group while the RRa was 0.99 （tl. 78, 1.25） for the OBI group. The multiple linear regression showed that the regression coefficient was 0.09 （ - 0.14,0.31） of gestational weeks against HBV infection groups. Conclusions Our results show that infection with occult or overt HBV does not have an obvious correlation with prmerm birth.