慢性HBV感染者妊娠期糖尿病对母婴结局的影响

Influence of chronic HBV infection on maternal and neonatal outcomes of women with gestational diabetes mellitus

关于妊娠期慢性HBV感染与妊娠期糖尿病(GDM)之间关系的研究较少,且结论不一致。2018年一项包含23个队列研究的荟萃分析中,发现妊娠期HBsAg阳性的孕妇发生GDM的风险更高,而且在不同的地理区域和研究人群中的结论是一致的。虽然研究证实HBV感染与GDM之间存在相关性,但其潜在机制尚不清楚。分析了慢性HBV感染造成GDM发生的可能机制,探讨了慢性HBV感染对GDM母婴结局的影响,提出了“全面二孩”政策实施后HBV感染妇女带来的挑战,如何加强慢性HBV感染妊娠期母体和新生儿的监控,减少母婴各类并发症仍是医务工作者努力的目标。

There are relatively few studies on the association between chronic hepatitis B virus( HBV) infection during pregnancy and gestational diabetes mellitus( GDM),with inconsistent conclusions. A meta-analysis of 23 cohort studies conducted in 2018 showed that HBs Ag-positive pregnant women had a higher risk of GDM,which was consistent across the populations from different geographical regions and studies. Although studies have confirmed the association between HBV infection and GDM,the underlying mechanism remains unclear. This article analyzes the possible mechanism of GDM caused by HBV infection,investigates the influence of chronic HBV infection on maternal and neonatal outcomes of women with GDM,and discusses the challenge for women with HBV infection after the implementation of the"universal two-child policy". It is still a goal for medical workers to strengthen the monitoring of pregnant women with chronic HBV infection and neonates and reduce the complications of mothers and neonates.