Analysis on the outcomes of hepatitis B virus perinatal vertical transmission: nested case-control study.

Objective: Hepatitis B virus (HBV) infection is a public health problem worldwide, with vertical transmission as the leading transmission route. Therefore, it is very important to explore the risk factors associating with HBV perinatal transmission, providing valuable information for preventive and curative means for HBV perinatal infections. In this study, we systematically investigated the impact of adverse outcomes of HBV maternal infection on fetal intrauterine infection.

Patients And Methods: This is a nested case-control study that included 42 hepatitis B surface antigen (HBsAg)-positive pregnant women. Gestational weeks, delivery modes, alanine aminotransferase levels, platelet counts, liver ultrasonography results as well as adverse pregnancy outcomes for the pregnant mothers and Apgar scores at both 1 and 5 min, birth weight, and height for the newborn infants were recorded. Vein blood from pregnant mothers and cord blood immediately after delivery were collected for the detection of HBsAg, antibodies to hepatitis B surface antigen, hepatitis B e antigen (HBeAg), antibody to hepatitis B e antigen, hepatitis B core antigen, and HBV DNA. Placental tissues were collected for detection of HBV DNA.

Results: Positive HBeAg as well as HBV DNA in the mother's serum were correlated closely with HBV intrauterine infection. Mother's age, delivery mode, alanine aminotransferase, blood platelet count, clinical HBV infection features, premature labor, gestational diabetes mellitus, pre-eclampsia, fetal growth retardation, fetal distress, Apgar scores of the infant as well as the HBV infection status of the placenta all failed to show a statistically significant correlation with intrauterine infection.

Conclusion: High level of HBV in maternal blood was one of the risk factors accounting for intrauterine infection.