Relationship between HBV RNA level and pregnancy outcomes among hepatitis B carriers.

Background: This study aims to investigate the relationship between hepatitis B virus (HBV) RNA level and pregnancy outcomes among hepatitis B carriers.

Methods: This study collected pregnant women who attended the Affiliated Hospital of Guizhou Medical University (Guizhou, China) from June 2020 to June 2023. The levels of HBV DNA, HBV RNA, and HBeAg status in HBV carriers were detected. Pregnancy outcomes including intrahepatic cholestasis of pregnancy (ICP), gestational hypertension (GH), pre-eclampsia, gestational diabetes mellitus (GDM), preterm prelabour rupture of membranes (PPROM), mode of delivery, preterm birth, low birth weight (LBW) and macrosomia.

Results: A total of 562 pregnant women were collected, 203 (36.12%) were infected with HBV. Compared with HBsAg negative, HBsAg positive pregnant women had a higher risk of ICP. There were no significant differences in the rates of GDM, GH, pre-eclampsia, PPROM, preterm birth, LBW, macrosomia, and mode of delivery among women in the two groups. Multivariate logistic regression analysis showed that maternal HBV RNA level (OR = 3.814, 95% CI: 2.036~7.142, P< 0.001) was an independent risk factor for ICP in HBsAg-positive pregnant women. The receiver operating characteristics (ROC) curve revealed that the areas under the curve of HBV RNA for prediction of ICP was 0.8652(95% confidence interval 0.7636-0.9669, P< 0.001).

Conclusions: The HBV RNA level has a significant negative impact on pregnancy outcomes. It may serve as an indicator to guide the prevention of ICP and improve maternal health.