Inactive Hepatitis B Carrier and Pregnancy Outcomes: A Systematic Review and Meta–analysis
Abstract
Background: We aimed to explore whether maternal asymptomatic hepatitis B (HB) infection effects on pre-term rupture of membranous (PROM), stillbirth, preeclampsia, eclampsia, gestational hypertension, or antepartum hemorrhage.
Methods: We searched the PubMed, Scopus, and ISI web of science from 1990 to Feb 2015. In addition, electronic literature searches supplemented by searching the gray literature (e.g., conference abstracts thesis and the result of technical reports) and scanning the reference lists of included studies and relevant systematic reviews. We explored statistical heterogeneity using the, I2 and tau-squared (Tau2) statistical tests.
Results: Eighteen studies were included. Preterm rupture of membranous (PROM), stillbirth, preeclampsia, eclampsia, gestational hypertension and antepartum hemorrhage were considerable outcomes in this survey. The results showed no significant association between inactive HB and these complications in pregnancy. The small amounts of P-value and chi-square and large amount of I2 suggested the probable heterogeneity in this part, which we tried to modify with statistical methods such as subgroup analysis.
Conclusion: Inactive HB infection did not increase the risk of adversely mentioned outcomes in this study. Further, well-designed studies should be performed to confirm the results.
Alavian SM, Ebrahimi E, Abedini M (2016). Necessity for HBs Ag screening in pregnant women in Iran, needed now. Iran Red Crescent Med J, (In Press):e40844.
Lavanchy D (2004). Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat, 11(2):97–107.
Karimi-Sari H, Tajik M, Bayatpoor ME, Alavian SM (2017). Increasing the Awareness of the General Population: An Important Step in Elimination Programs of Viral Hepatitis. Am J Gastroenterol, 112 (2): 393-395.
Alavian SM, Nikfar S, Kebriaeezadeh A, Lotfi F, Sanati E, Rezaei Hemami M, Keshavarz K (2016). A Cost-Utility Analysis of Different Antiviral Medicine Regimens in Patients with Chronic Hepatitis C Virus Genotype 1 Infection. Iran Red Crescent Med J, 18(11): e37094.
Mirmomen S, Alavian SM, Hajarizadeh B, Yektaparast B, Zahedi MJ, Zand V, Azami AA, Hosseini MM, Faridi AR, Davari K, Hajibeigi B (2006). Epidemiology of Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus Infecions in Patients with Beta-Thalassemia in Iran: A Multicenter Study. Arch Iran Med, 9 (4): 319 – 323.
Alavian SM (2017). Decreasing the hepatitis B burden in Tunisia need more attention to adults for vaccination. Epidemiol Infect, 145(7):1512.
Pastorek JG, Miller JM, Summers PR (1988). The effect of hepatitis B antigenemia on pregnancy outcome. Am J Obstet Gynecol, 158 (3 Pt 1): 486-9.
Wong S, Chan LY, Yu V, Ho L (1999). Hepatitis B carrier and perinatal outcome in singleton pregnancy. Am J Perinatol, 16 (9): 485-8.
DegliEsposti S, Shah D (2011). Hepatitis B in Pregnancy: Challenges and Treatment. Gastroenterol Clin North Am, 40 (2): 355-72.
Lao TT, Sahota DS, Suen SS, Lau TK, Leung TY (2010). Chronic hepatitis B virus infection and rubella susceptibility in pregnant women. J Viral Hepat, 17 (10): 737-41.
Elefsiniotis I, Tsoumakas K, Vezali E, Glynou I, Drakoulis N, Saroglou G (2010). Spontaneous preterm birth in women with Hepatitis B virus infection. Int J Gynaecol Obstet, 110 (3): 241–4.
Reddick KL, Jhaveri R, Gandhi M, James AH, Swamy GK (2011). Pregnancy outcomes associated with viral hepatitis. J Viral Hepat, 18 (7): e394–8.
Lao TT, Chan BC, Leung WC, Ho LF, Tse KY (2007). Maternal Hepatitis B infection and gestational diabetes mellitus. J Hepatol, 47 (1): 46–50.
Lao TT, Sahota DS, Suen SS, Law LW, Leung TY (2012). Maternal HBs Ag status and infant size–a Faustian bargain?.J Viral Hepat, 19 (7): 519–24.
Saleh-Gargari S, Hantoushzadeh S, Zendehdel N, Jamal A, Aghdam H (2009). The Association of Maternal HBs Ag Carrier Status and Perinatal Outcome. Hepat Mon, 9 (3): 180–4.
Safir A, Levy A, Sikuler E, Sikuler E, Sheiner E (2010). Maternal Hepatitis B virus or hepatitis C virus carrier status as an independent risk factor for adverse perinatal outcome. Liver Int, 30 (5): 765–70.
Ebrahimi E, Keramat A, Yunesian M, Alavian SM, Khosravi A, Montazeri A, Abedini M (2016). Maternal inactive hepatitis B Status and Birth-Outcomes: A Systematic Review and Meta-Analysis. Iran Red Crescent Med J, 18 (11): e 31820.
Lao TT, Sahota DS, Cheng YK, Law LW, Leung TY (2013). Maternal Hepatitis B surface antigen status and incidence of pre eclampsia. J Viral Hepat, 20 (5): 343-9.
Vandenbroucke JP, Elm Ev, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M (2007). Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Epidemiology, 18(6):805-35.
Connell LE , Salihu HM , Salemi JL , August EM, Weldeselasse H, Mbah AK (2011). Maternal Hepatitis B and hepatitis C carrier status and perinatal outcomes. Liver Int, 31 (8): 1163-70.
MAK SL, leung KY (2013). Hepatitis B Carriers in Hong Kong, Prevalence and Pregnancy Outcomes. HKJGOM , 13 (1):67-73.
LU Y, Chen YP, Xiao X, Liang X, Li J, Huang S, Chen X, Hocher B (2012). Impact of maternal Hepatitis B surface antigen carrier status on preterm delivery in southern China. Nan Fang Yi Ke Da Xue Xue Bao, 32 (9): 1369-72.
Moga M, Anastasiu C, bagiu N (2012). Is maternal HBs Ag carrier status associated with adverse pregnancy outcome? Obstetrics, 9 (31): 8-10.
Lobstein S, Faber R, Tillmann HL (2011). Prevalence of Hepatitis B among Pregnant Women and Its Impact on Pregnancy and Newborn Complications at a Tertiary Hospital in the Eastern Part of Germany. Digestion, 83 (1-2): 76–82.
Higgins JPT, Green S (2008). Cochrane handbook for systematic reviews of interventions Version 5.0.0: The Cochrane Collaboration. http://handbook.cochrane.org/v5.0.0/
RevMan. Review Manager (RevMan) [Computer program] (2008). RevMan. Version 5.0 for Windows. Copenhagen: The Nordic Cochrane Centre, the Cochrane Collaboration. http://community.cochrane.org/tools/review-production-tools/revman-5/about
Stata Corp (2009). Stata Statistical Software: Release 11. College Station, TX: StataCorp LP. http://www.stata.com/support/faqs/resources/citing-software-documentation-faqs/
Aghamohammadi A, Nooritajer M (2011). Maternal Hbsag Carrier and Pregnancy Outcome. Aust J Basic Appl Sci, 5(3): 607-610.
Tse KY, Ho LF, Lao T (2005). The impact of maternal HBs Ag carrier statuson pregnancy outcomes: A case–control study. J Hepatol, 43 (5):771–5.
Lert-amornpong S, Caengow S, Chutaputti A (2007). The Association of Pregnancy Outcomes and HBs Ag Positive. Thai J Gastroenterol, 8 (3): 115-118.
TO WW, Cheung W, Mok Km (2003). Hepatitis B surface antigen carrier status and its correlation to gestational hypertension. Aust N Z J Obstet Gynaecol, 43 (2): 119–122.
Sirinart S, Kuntharee T, Pannee S, Theera T (2014). Pregnancy outcomes among carriers of Hepatitis B virus. Int J Gynaecol Obstet, 126 (2): 106-10.
Huang X, Tan H, Li X, Zhou S, Wu Wen S, Luo M (2014). Maternal chronic HBV infection would not increase the risk of pregnancy-induced hypertension--results from pregnancy cohort in Liuyang rural China. PLoS One, 9 (12): e114248.
Borenstein M, Hedges L, Rothstein H (2007). Meta-analysis: fixed effect vs. random effects. John Wiley and Sons Ltd Inc, pp: 11-21.
Lindheimer A, Katz AI (1989). Preeclampsia: pathophysiology, diagnosis, and management. Annu Rev Med, 40: 233-50.
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Issue | Vol 46 No 4 (2017) | |
Section | Review Article(s) | |
Keywords | ||
Inactive hepatitis B Pregnancy outcome Pregnancy adverse effect |
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