妊娠合并乙肝病毒感染与早产的相关性研究

The relationship between pregnancy complicated with hepatitis B virus infection and premature delivery

目的探讨妊娠合并乙肝病毒感染与早产的相关性。方法将2013年1月至2016年12月在福建省妇幼保健院规律产前检查并分娩的单胎妊娠27819名孕妇纳入队列研究。根据分娩孕周分为足月组(妊娠≥37周,26476例)、晚期早产组(妊娠34~36周+6,1083例)和早中期早产组(妊娠28~33周+6,260例),比较三组孕妇一般基线资料、妊娠期并发症及合并症,采用有序logistics回归调整混杂因素分析乙肝病毒感染与早产的相关性。结果早中期早产组和晚期早产组乙肝病毒感染率高于足月组(13.5%,2416/26476;10.6%,115/1083;9.1%,35/260),但仅早中期早产组与足月组乙肝病毒感染率比较,差异有统计学意义(P=0.016)。通过有序logistics回归逐步校正混杂因素后发现,乙肝病毒感染是早产的独立危险因素(a OR=1.205,95%CI:1.009~1.440)。结论妊娠合并乙肝病毒感染增加早产风险,临床上应重视乙肝病毒感染孕妇的孕期保健,以减少早产的不良妊娠结局。

Objective To explore the association between hepatitis B virus(HBV)infection and premature delivery.Methods We included 27819 women who had a card established in the Fujian Maternity and Child Health Hospital from January 2013 to December 2016 in a retrospective cohort study.Participants were divided into three groups according to gestational week:full term group(26476 cases),late preterm delivery group(1083 cases)and early to midterm preterm delivery group(260 cases).We compared the difference among the three groups and further used ordinal polytomous logistic regression to analyze the association between HBV infection and premature delivery.Results The incidence of HBV infection in late preterm delivery group and the early to mid-term preterm delivery group was higher than that of the full term group(13.5%,2416/26476;10.6%,115/1083;9.1%,35/260),however,only the difference between late preterm delivery group and the full term group had statistically significance(P=0.016).We found that HBV infection was an independent risk factor for premature delivery(a OR=1.205,95%CI:1.009-1.440)after correcting confounding factors through ordinal polytomous logistic regression.Conclusion HBV infection increases the risk of premature delivery.Comprehensive programmes focusing on pregnant women with HBV infection during pregnancy would be helpful to reduce the incidence of adverse outcomes.