1115 A comparison of maternal and neonatal outcomes in acute and chronic hepatitis B

Abstract

We sought to estimate differences in maternal and neonatal outcomes between acute hepatitis B (HBV) infections and chronic HBV infections in pregnancy. We conducted a retrospective cohort study of patients with singleton, non-anomalous births in California from 2007 to 2011. We included only those with gestational ages between 27 and 42 weeks. We evaluated maternal outcomes using occurrence of gestational hypertension, gestational diabetes, preterm delivery, mild to severe preeclampsia, eclampsia, severe maternal morbidity, rupture of membranes before thirty-seven weeks gestation and induction of labor. We evaluated neonatal outcomes using neonatal death (within six weeks of birth), infant death (within one year of birth), NICU admissions over twenty-four hours, birth injuries and hypoxic ischemia encephalopathy. Analysis was performed with chi-square tests using a significance cutoff of 0.05 and logistic multivariate regressions controlling for ethnicity, age, parity, basal metabolic index, smoking status, insurance type and education level. In a California cohort of 2,805 pregnant individuals with confirmed HBV infections, 1370 (49%) had acute infections and 1435 (51%) had chronic infections. Gestational diabetes (aOR 1.40, 95% CI 1.09-1.79) , pre-eclampsia (aOR 1.81, 95% CI 1.11-2.93) and premature rupture of membranes (aOR 1.95, 95% CI 1.39-2.74) were statistically significantly different for women with chronic infections (Table 1). No statistically significant differences were observed between the two groups (Table 2). The occurrence of neonatal death, infant death and hypoxic ischemia encephalopathy in both groups was insignificant. In this analysis, chronic HBV infected persons had significantly different maternal outcomes compared to those with acute infections in pregnancy however, infants born to women with acute and chronic hepatitis B infections showed no difference in neonatal outcomes.View Large Image Figure ViewerDownload Hi-res image Download (PPT)