Prevalence of asymptomatic hepatitis B virus infection in intrahepatic cholestasis of Pregnancy and its impact on pregnancy outcome

Abstract

Abstract: Objective To investigate the prevalence of asymptomatic hepatitis B virus infection in intrahepatic cholestasis of pregnancy and its impact on pregnancy outcome.Methods A total of 112 pregnant women with chronic HBV infection, who were admitted for treatment and underwent pregnancy termination between January 2018 and December 2022, were included in the study. Based on fasting bile acid levels during pregnancy, participants were classified into a high bile acid group (TBA ≥ 10 μmol/L) (n=56) and a low bile acid group (TBA<10 μmol/L) (n=56). Baseline characteristics, serological markers, and pregnancy outcomes were compared between the two groups.Results Comparison of baseline data revealed that the proportion of elderly individuals in the high bile acid group was 37.5%, significantly higher than that in the low bile acid group (19.6%) (P<0.05). Serological analysis showed that the ratios of ALTmax>40 (U/L) ratio, ASTmax >35 (U/L), GGTmax >32 (U/L), and DNAmax >2×10⁵ (IU/mL) in the high bile acid group were 64.2%, 64.2%, 33.9% and 64.2% respectively, significantly higher than those in the low bile acid group (12.5%, 17.8%, 5.3% and 23.2%) (P<0.05). Regarding pregnancy outcomes, the high bile acid group had a significantly higher incidence of preterm birth (14.2%) and cesarean section (71.43%) compared to the low bile acid group (3.5% and 35.7%, respectively) (P<0.05). The mean gestational age at delivery in the high bile acid group was 37.8 ±1.5 weeks, significantly lower than the low bile acid group (38.8±1.5 weeks) (P<0.05)].Conclusion Pregnant women with intrahepatic cholestasis of pregnancy exhibit a higher incidence of adverse pregnancy outcomes and a greater prevalence of asymptomatic hepatitis B virus infection. Closer monitoring is recommende for pregnant women with elevated bile acid levels.

Key words: Pregnancy, Intrahepatic cholestasis, Hepatitis B virus

QIAN Er-yan, GONG Mi, WANG Li-juan, LIU Yu. Prevalence of asymptomatic hepatitis B virus infection in intrahepatic cholestasis of Pregnancy and its impact on pregnancy outcome[J]. Chinese Hepatolgy, 2024, 29(12): 1558-1560.

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