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目的探析乙型肝炎病毒(HBV)感染与妊娠结局的关系。方法分析分娩、产前检查以及孕期初诊的42例HBV感染(血清HBs Ag阳性)孕妇的临床资料,选取同期62例肝功能正常的血清HBs Ag阴性孕妇作为对照组,根据丙酸氨基转氨酶(ALT)水平把患者分为肝功能正常组29例和肝功能异常组13例,比较3组的基线资料、分娩、妊娠并发症情况以及婴儿围生期结局情况。结果 3组孕妇的孕周、孕次、年龄间差异无统计学意义(P>0.05)。3组孕妇妊娠并发症中产后出血、胎膜早破、妊娠期高血压、胎儿窘迫、早产的发生率异常组最高,对照组最低。异常组和对照组相比,产后出血、早产以及妊娠期高血压发生率差异有统计学意义(P<0.05),胎膜早破及胎儿窘迫的发生率差异无统计学意义(P>0.05);正常组妊娠并发症的发生率与对照组差异无统计学意义(P>0.05)。3组孕妇的剖宫产率差异无统计学意义(P>0.05)。3组孕妇婴儿围生期结局中,异常组出现死胎、低体重儿和新生儿窒息的几率最高,其中低体重儿的发生率与对照组差异有统计学意义(P<0.05)。结论伴发HBV感染的妊娠对母婴结局的影响不良,特别是肝功能异常孕妇对母婴的危害更大。
Objective To explore the relationship between hepatitis B virus (HBV) infection and pregnancy outcome. Methods The clinical data of 42 pregnant women with HBV infection (serum HBs Ag positive) during delivery, prenatal examination and first trimester pregnancy were analyzed. Totally 62 pregnant women with normal liver function were enrolled as control group. According to ALT ) Patients were divided into normal liver function group (n = 29) and abnormal liver function group (n = 13). Baseline data, delivery, pregnancy complications and infant perinatal outcome were compared between the three groups. Results There were no significant differences in gestational age, gestational age and age between the three groups (P> 0.05). The incidence of postpartum hemorrhage, premature rupture of membranes, pregnancy-induced hypertension, fetal distress and preterm birth were the highest in the three groups and the lowest in the control group. There were significant differences in the incidence of postpartum hemorrhage, premature labor and gestational hypertension between the abnormal group and the control group (P <0.05), the difference of premature rupture of membranes and fetal distress was not statistically significant (P> 0.05) The incidence of pregnancy complications in normal group was not significantly different from that in control group (P> 0.05). There was no significant difference in cesarean section rate between the three groups (P> 0.05). The incidence of stillbirth in the abnormal group, the incidence of asphyxia in low birth weight infants and newborns were the highest among the three groups of pregnant women with perinatal outcome. The incidence of low birth weight infants was significantly different from that of the control group (P <0.05). Conclusion Pregnancy with HBV infection has a poor effect on the outcomes of maternal and infant, especially for pregnant women with abnormal liver function.