The following is a summary of “Effect of intrahepatic cholestasis in pregnancy combined with different stages of hepatitis B virus infection on pregnancy outcomes: a retrospective study,” published in the April 2024 issue of Obstetrics and Gynaecology by Gao et al.
Investigating the impact of intrahepatic cholestasis of pregnancy (ICP) in conjunction with hepatitis B virus (HBV) infection on pregnancy outcomes is paramount for comprehensive prenatal care. In this study, a cohort of 512 pregnant women was meticulously analyzed, considering maternal demographics, adverse pregnancy outcomes, and markers of HBV infection, including HBeAg and HBV-DNA loads. Among the participants, 319 exhibited solitary ICP without HBV infection (Group I), while 193 were diagnosed with both conditions. Among the latter group, 118 cases presented abnormal liver function (Group II), and 80 cad normal liver function (Group III). Subsequent stratification revealed further nuances: HBV-infected pregnant women with ICP were categorized based on HBeAg positivity (102 cases) or negativity (91 cases) and viral load levels (high: 92 cases, moderate: 46 cases, low: 55 cases). Group II, characterized by abnormal liver function, exhibited elevated serum total bile acids, transaminase, and bilirubin levels, alongside a higher incidence of premature delivery, neonatal intensive care unit (NICU) admissions, and meconium-stained amniotic fluid (MSAF) compared to the other cohorts (P < 0.05).
Conversely, no significant differences were observed in these parameters between Group I and Group III. Notably, HBeAg-positive individuals displayed heightened serum transaminase, bilirubin, and bile acid levels, earlier gestational delivery, lower newborn birth weights, and increased NICU admissions compared to their HBeAg-negative counterparts (P < 0.05). Similarly, those with high HBV-DNA loads (>106 IU/ml) manifested elevated liver enzymes, bilirubin, and bile acid levels, alongside shorter gestational periods, reduced newborn birth weights, and augmented NICU admissions relative to individuals with moderate or low viral loads (P < 0.05). This comprehensive analysis underscores the significance of vigilant management for HBV-infected pregnant women with ICP, particularly those exhibiting abnormal liver function, HBeAg positivity, or high viral loads, advocating for tailored interventions to mitigate adverse pregnancy outcomes effectively.
Source: bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-024-06460-9