Abstract
Background and Aim: Chronic hepatitis B and its effects on pregnancy are variable. Some studies have shown a higher risk for preterm delivery, antepartum haemorrhage and gestational diabetes. The presence of hepatitis B envelope antigen (HBeAg) and high maternal DNA increases the risk of mother to child transmission (MCT). The objective of our study was to detect the frequency of clinical flares, liver function abnormalities, pattern of serological markers, maternal and foetal outcome in pregnant women with chronic hepatitis B. Methods: All records of women with chronic hepatitis B in pregnancy between January 2014 and June 2016 were included. Demographic details, parity, gestational age at presentation, clinical symptoms, liver function tests, viral markers (HBeAg, Anti HBe, and HBV DNA quantification), timing and mode of delivery, birth weight and pregnancy outcome details were collected. Results: A total of 205 women with chronic hepatitis B were seen during the study period. Their mean age was 25.1 + 8.1 years. 108 (52.7%) women were multiparous with half of them (n = 55) being aware of their antigen status in previous pregnancy. 52.2% (n = 107) of women presented in third trimester. There was no symptom flare during pregnancy or immediate postpartum. HBeAg was positive in 24 and negative in 154. HBV DNA was less than 2000 IU/ml in 122, 2000–20000 IU/ml in 17, 20,000–200,000 IU/ml in 8 and more than 200,000 IU/ml in 23 women. Alanine transaminase was elevated in four women. 15 women with very high DNA received tenofovir in third trimester. Majority of women (93.7%) underwent normal vaginal delivery. Preterm delivery and low birth weight was seen in 6.3% and 6.7% respectively. Conclusion: In conclusion, majority of women with hepatitis B presented late in pregnancy. Serological markers indicating an increased risk for MCT was observed in 11.8%. We did not find any adverse maternal or fetal outcome in our women. The authors have none to declare.
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