Abstract: Objective To explore the effects of medication intervention strategies during pregnancy on the prognosis of maternal and infant and the occurrence of postpartum hepatitis in patients with hepatitis B viral infection during pregnancy. Methods A retrospective analysis was conducted on 102 pregnant women with hepatitis B viral (HBV) infection who were admitted to Nantong Third Affiliated Hospital of Nantong University from January 2018 to January 2023. Based on the duration of treatment intervention, the participants were categorized into an observation group consisting of 56 cases and a control group comprising 46 cases. On the second day after enrollment, the observation group began oral treatment with tenofovir. The control group started taking oral tenofovir treatment from 24 weeks of pregnancy. The serum level of alanine aminotransferase (ALT), peripheral blood HBV DNA load and the negative rate of hepatitis B e antigen (HBeAg) were compared between the two groups at each time point. The outcomes of pregnancy, neonatal HBV DNA positive infection rate, and postpartum hepatitis incidence rate in pregnant women were recorded. Results At 6 weeks, 12 weeks, and 24 weeks of pregnancy, the serum ALT and HBV DNA levels in the observation group were lower than those in the control group (all P<0.05). At 6 weeks postpartum, no statistically significant differences were observed in serum ALT and HBV DNA levels between the two groups (both P>0.05). At 6 weeks, 12 weeks, 24 weeks, 36 weeks of pregnancy, and 6 weeks postpartum, there was no statistically significant difference in the HBeAg seroconversion rates between the observation group and the control group [0.00%, 1.79%, 5.36%, 5.36%, 0.00% vs 0.00%, 0.00%, 0.00%, 2.17%, 0.00%] (all P>0.05). There was no statistically significant difference between the two groups in terms of preterm birth, premature rupture of membranes, postpartum hemorrhage, intrauterine distress, and hyperbilirubinemia (all P>0.05). The incidence of postpartum hepatitis in the observation group was 33.93%, which was lower than that in the control group (58.70%, P<0.05), and the positive infection rate of HBV DNA in newborns was lower than that in the control group (P<0.05). Conclusion Early initiation of antiviral therapy during pregnancy can help reduce maternal prenatal viral load, improve the blocking effect of mother to child transmission, and reduce the occurrence of postpartum hepatitis in mothers.

Key words: Hepatitis B virus, Pregnancy, Timing of treatment, Maternal and infant outcomes, Postpartum hepatitis