乙型肝炎病毒感染对妊娠期糖尿病孕妇的结局分析

doi:10.3969/j.issn.1000-8535.2023.09.002

广州医药 ›› 2023, Vol. 54 ›› Issue (9): 11-15.DOI: 10.3969/j.issn.1000-8535.2023.09.002

乙型肝炎病毒感染对妊娠期糖尿病孕妇的结局分析

赵己未¹, 沙晓燕², 伍金娟², 吴雪², 张国正²

1 广州中医药大学金沙洲医院消化内科（广东广州 510400）;
2 广州市妇女儿童医疗中心产科（广东广州 510623）

收稿日期:2023-04-23 出版日期:2023-09-20 发布日期:2023-10-12
通讯作者: 张国正,E-mail：zhang710923@163.com
基金资助:
国家自然科学基金（81701456）

Analysis of outcome in gestational diabetes mellitus pregnant women with hepatitis B virus infection

ZHAO Jiwei¹, SHA Xiaoyan², WU Jinjuan², WU Xue², ZHANG Guozheng²

1 Department of Gastroenterology,Jinshazhou Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510000,China;
2 Department of Obstetrics,Guangzhou Women and Children’s Medical Center,Guangzhou 510623,China

Received:2023-04-23 Online:2023-09-20 Published:2023-10-12

摘要/Abstract

摘要： 目的探讨慢性乙型肝炎病毒（HBV）感染对妊娠期糖尿病（GDM）孕妇的妊娠并发症、孕晚期生殖道B族链球菌（GBS）感染情况以及妊娠结局的影响。方法选取2020年1月1日—12月31日在广州市妇女儿童医疗中心定期产检、足月、单胎妊娠的GDM孕妇共583例,其中合并HBV感染者（GDM+HBV组）48例,无合并者（GDM组）535例。比较2组的妊娠期并发症、妊娠晚期（妊娠35~37周）生殖道GBS感染情况、妊娠结局以及阴道分娩者的母儿结局。结果与GDM组患者相比,GDM+HBV组患者出现妊娠期肝内胆汁淤积症、孕晚期生殖道GBS感染者比例较高,孕期出现胎盘早剥者比例较高,阴道分娩过程中出现产时发热、羊水粪染和新生儿入住NICU者比例均较高（均P<0.05）。结论与无合并慢性HBV感染的GDM患者相比,合并慢性HBV感染的GDM患者在围产期的母儿风险升高。

关键词: 妊娠期糖尿病, 慢性乙型肝炎病毒感染, B族链球菌感染, 妊娠结局

Abstract: Objective To investigate the effects of chronic hepatitis B virus（HBV）infection on pregnancy complications,group B streptococcus（GBS）infection in third trimester and pregnancy outcome in pregnant women with gestational diabetes mellitus（GDM）．Methods A retrospective study of 583 pregnant women with GDM,singleton gestation and cephalic presentation delivered at term in Guangzhou Women and Children’s Medical Center was carried out．Including 48 GDM women complicated with chronic HBV infection（GDM+HBV group）and 535 GDM women without HBV infection（GDM group）．Pregnancy complications,GBS infection in third trimester（gestation 35-37 weeks）,pregnancy outcomes,maternal and neonatal outcomes of vaginal delivery were compared between the two groups．Results GDM+HBV group had a higher proportion of intrahepatic cholestasis of pregnancy（ICP）and GBS infection in third trimester than GDM group,and a higher proportion of placental abruption during pregnancy．GDM+HBV group showed a significantly increased proportion in intrapartum fever,meconium-stained amniotic fluid and neonatal intensive care unit admission during vaginal delivery than GDM group（all P<0.05）．Conclusions GDM women with chronic HBV infection are associated with increased maternal and fetal risk during pregnancy and delivery．

Key words: gestational diabetes mellitus, chronic hepatitis B virus infection, group B streptococcus infection, pregnancy outcomes

赵己未, 沙晓燕, 伍金娟, 吴雪, 张国正. 乙型肝炎病毒感染对妊娠期糖尿病孕妇的结局分析[J]. 广州医药, 2023, 54(9): 11-15.

ZHAO Jiwei, SHA Xiaoyan, WU Jinjuan, WU Xue, ZHANG Guozheng. Analysis of outcome in gestational diabetes mellitus pregnant women with hepatitis B virus infection[J]. Guangzhou Medical Journal, 2023, 54(9): 11-15.

参考文献

[1] 中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2022年版)[J].中华传染病杂志,2023,41(1):3-28.
[2] 中华医学会妇产科学分会产科学组,中华医学会围产医学分会.乙型肝炎病毒母婴传播预防临床指南(2020)[J].中华围产医学杂志,2020,23(5):289-298.
[3] SIRILERT S,TONGSONG T.Hepatitis B Virus infection in pregnancy:immunological response,natural course and pregnancy outcomes[J].J Clin Med,2021,10(13):2926.
[4] CHEN Y,PENG L,HE J,et al.Impact of hepatitis B virus infection on maternal and infant outcomes of women with gestational diabetes mellitus:A three-year retrospective study[J].J Diabetes Complications,2022,36(6):108201.
[5] ZHANG Y,CHEN J,LIAO T,et al.Maternal HBsAg carriers and pregnancy outcomes:a retrospective cohort analysis of 85,190 pregnancies[J].BMC Pregnancy Childbirth,2020,20(1):724.
[6] WANG T,ZHOU W,JIANG R,et al.Predictive factors associated with disease recurrence in patients with severe intrahepatic cholestasis of pregnancy:a retrospective study of 118 cases[J].J Matern Fetal Neonatal Med,2022,35(25):6807-6814.
[7] WAN Z,ZHOU A,ZHU H,et al.Maternal Hepatitis B Virus infection and pregnancy outcomes:A hospital-based case-control study in Wuhan,China[J].J Clinl Gastroenterol,2018,52(1):73-78.
[8] 杨梦楠,花晓琳,金敏菲,等.妊娠期B族链球菌感染现状及对母儿结局的影响[J].现代妇产科进展,2019,28(3):173-177.
[9] SHABAYEK S,SPELLERBERG B.Group B streptococcal colonization,molecular characteristics,and epidemiology[J].Front Mierobiol,2018(9):437.
[10] ZHAO X,BAI X,XI Y.Intrauterine infection and mother-to-child transmission of Hepatitis B Virus:Route and molecular mechanism[J].Infect Drug Resist,2022(15):1743-1751.
[11] VYAS A K,RAMAKRISHNA U,SEN B,et al.Placental expression of asialoglycoprotein receptor associated with Hepatitis B virus transmission from mother to child[J].Liver Int,2018,38(12):2149-2158.
[12] XIONG Y,LIU C,HUANG S,et al.Impact of maternal infection with hepatitis B virus on pregnancy complications and neonatal outcomes for women undergoing assisted reproductive technology treatment:A population‐based study[J].J Viral Hepat,2021,28(4):613-620.
[13] HUANG Q T,CHEN J H,ZHONG M,et al.The risk of placental abruption and placenta previa in pregnant women with chronic hepatitis B viral infection:a systematic review and meta-analysis[J].Placenta,2014,35(8):539-545.

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乙型肝炎病毒感染对妊娠期糖尿病孕妇的结局分析

Analysis of outcome in gestational diabetes mellitus pregnant women with hepatitis B virus infection

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