Abstract

BackgroundWe encourage Hepatitis B virus-infected mothers to breastfeed postpartum, even when continuing pregnancy category B nucleos(t)ide analogs (NAs) treatment. However, a large proportion of the Hepatitis B virus-infected mothers were noncompliant with this breastfeeding recommendation. This study aimed to investigate the factors associated with noncompliance with breastfeeding recommendation in Hepatitis B virus-infected mothers who had received NAs treatment during pregnancy.MethodsA total of 155 mothers with chronic hepatitis B receiving NAs treatment for preventing mother-to-child transmission during the late gestation period were included and divided into exclusive breastfeeding (n = 63), mixed feeding (n = 34), and artificial feeding (n = 58) groups according to the postpartum feeding methods. Independent variables associated with feeding methods were analyzed using logistic regression analysis.ResultsCompared to the breastfeeding and mixed feeding groups, the artificial feeding group had significantly more multiparity, later postpartum timing of stopping NAs treatment, and a lower proportion of having knowledge of NAs medications (all P < 0.05). In addition, multivariable logistic regression analysis confirmed that multiparity, later postpartum timing of stopping NAs treatment, and lacking knowledge of medication were independent factors associated with noncompliance with breastfeeding recommendation.ConclusionsHepatitis B virus-infected mothers who stopped NAs treatment at late postpartum period or had less knowledge of medication were more likely to be noncompliant with breastfeeding recommendation. Strengthening health education for participants taking NAs may be an important method to improve compliance with breastfeeding recommendation.

Highlights

  • We encourage Hepatitis B virus-infected mothers to breastfeed postpartum, even when continuing pregnancy category B nucleos(t)ide analogs (NAs) treatment

  • Clinical studies in recent years have confirmed that nucleos(t)ide analogs (NAs) treatment, such as tenofovir disoproxil fumarate (TDF) and telbivudine (LDT), in the second and third trimesters of pregnancy can effectively reduce the Mother-to-child transmission (MTCT) of Hepatitis B virus (HBV) [7,8,9,10]

  • The purpose of this study was to investigate the factors associated with noncompliance with breastfeeding recommendation in HBV-infected mothers who had received NAs treatment during pregnancy for preventing MTCT

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Summary

Introduction

We encourage Hepatitis B virus-infected mothers to breastfeed postpartum, even when continuing pregnancy category B nucleos(t)ide analogs (NAs) treatment. The guidelines by several liver disease associations, including the Asian Pacific Association for the Study of the Liver (APASL) [11], the European Association for the Study of the Liver (EASL) [12], the National Institute for Health and Care Excellence (NICE) [13] and the American Association for the Study of Liver Diseases (AASLD) [14] all recommend high viral load chronic hepatitis B (CHB) pregnant women at the immune tolerance period to receive pregnancy category B NAs (such as TDF and LDT [15]) during the second and third trimesters to reduce the MTCT rate

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