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Maternal hepatitis B infection burden, comorbidity and pregnancy outcome in a low-income population on the Myanmar-Thailand border : a retrospective cohort study

Bierhoff, M. and Angkurawaranon, C. and Myat Min, A. and Gilder, M. E. and Win Tun, N. and Keereevijitt, A. and Kyi Win, A. and Win, E. and Carrara, V. I. and Brummaier, T. and Chu, C. S. and Thielemans, L. and Sriprawat, K. and Hanboonkunupakarn, B. and Rijken, M. and Nosten, F. and Vugt, M. V. and McGready, R.. (2019) Maternal hepatitis B infection burden, comorbidity and pregnancy outcome in a low-income population on the Myanmar-Thailand border : a retrospective cohort study. J Pregnancy, 2019. p. 8435019.

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Abstract

Objectives. Hepatitis B virus (HBV) was believed to have minimal impact on pregnancy outcomes apart from the risk of perinatal transmission. In more recent years, there have been reports of adverse associations, most consistently preterm birth (PTB), but this is in the context of high rates of caesarean section. The aim of this study was to explore the association of HBV on pregnancy outcomes in marginalized, low-income populations on the Myanmar-Thailand border. Methods. HBsAg positive (+) point of care rapid detection tests results were confirmed by immunoassays. Women with a confirmed HBsAg status, HIV- and syphilis-negative at first antenatal care screening, singleton fetus and known pregnancy outcome (Aug-2012 to Dec-2016) were included. Logistic regression analysis was used to evaluate associations between HBV group (controls HBsAg negative, HBsAg+/HBeAg-, or HBsAg+/HBeAg+) and pregnancy outcome and comorbidity. Results. Most women were tested, 15,046/15,114 (99.6%) for HBV. The inclusion criteria were not met for 4,089/15,046 (27.2%) women due mainly to unavailability of pregnancy outcome and nonconfirmation of HBsAg+. In evaluable women 687/11,025 (6.2%) were HBsAg+, with 476/11,025 (4.3%) HBsAg+/HBeAg- and 211/11,025 (1.9%) were HBsAg+/HBeAg+. The caesarean section rate was low at 522/8,963 (5.8%). No significant associations were observed between pregnancy comorbidities or adverse pregnancy outcomes and HBV status. Conclusions. The results highlight the disease burden of HBV in women on the Myanmar-Thailand border and support original reports of a lack of significant associations with HBsAg+ irrespective of HBeAg status, for comorbidity, and pregnancy outcomes in deliveries supervised by skilled birth attendants.
Faculties and Departments:03 Faculty of Medicine > Departement Public Health > Sozial- und Präventivmedizin > Medical Services (Neumayr)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medicine (MED) > Medical Services (Neumayr)
UniBasel Contributors:Brummaier, Tobias
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Hindawi
ISSN:2090-2727
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:01 Apr 2019 09:35
Deposited On:01 Apr 2019 09:34

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