Association between hepatitis B virus replication during pregnancy and perinatal outcomes: a retrospective cohort study.

BACKGROUND: The effect of hepatitis B virus (HBV) replication during pregnancy on the outcomes of pregnancies remains to be elucidated. OBJECTIVES: This study aimed to investigate the association between HBV replication and adverse maternal and infant outcomes. METHODS: We retrospectively analysed the clinical data of 836 pregnant inpatients with hepatitis B surface antigen positivity who delivered at two provincial tertiary grade A hospitals in the Fujian province between June 2016 and October 2020. RESULTS: The incidence of intrahepatic cholestasis of pregnancy, hypertensive syndrome complicating pregnancy, gestational diabetes mellitus, preterm birth, macrosomia, growth restriction, and vaginal infections did not differ in the HBV replication and non-replication groups (p > 0.05); however, the rates of caesarean section (p = 0.017; OR, 1.423; 95% CI, 1.065-1.902) and neonatal jaundice (p < 0.001; OR, 2.361; 95% CI, 1.498-3.721) were higher in the replication group than that in the non-replication group. After using propensity score analysis to adjust for alanine transaminase and aspartate aminotransferase levels in both groups, the replication group was still found to have an increased risk for caesarean section (p < 0.001; OR, 2.367; 95% CI, 1.668-3.359) and their infants had higher rates of neonatal jaundice (p < 0.001; OR, 12.605; 95% CI, 4.456-35.656). CONCLUSIONS: Our findings contribute to a better understanding of the association between maternal HBV replication status and perinatal outcomes. Pregnant women with HBV replication face an increased risk of caesarean section, and their infants appear to have a higher risk for neonatal jaundice.

Clinical analysis of the therapeutic effect of plasma exchange on hypertriglyceridemic acute pancreatitis: A retrospective study.

BACKGROUND: The therapeutic effect of plasma exchange (PE) on hypertriglyceridemic acute pancreatitis (HTGAP) is unclear. Therefore, we aimed to explore this therapeutic effect. STUDY DESIGN AND METHODS: This study included 204 patients with HTGAP who underwent treatment at two provincial tertiary grade A hospitals in Fujian Province from October 2012 to May 2021. Patients were divided into a conventional group and a PE group. The Student's t-test and chi-square test were used for data analysis. RESULTS: Among 204 patients, 56 and 148 were included in the PE and conventional groups, respectively. After propensity score matching (PSM), the PE and conventional groups each had 42 patients. There was no significant difference in age; sex; pregnancy; comorbidities; laboratory findings; incidences of complications, and multiple organ dysfunction syndrome (MODS); organ support treatment; surgical rate; mortality; and hospital stay between the groups (p > 0.05). The total expenses were significantly higher in the PE group than in the conventional group (p < 0.05). There was no statistically significant difference in the times of PE; total volume of PE; incidences of complications, and MODS; organ support treatment; surgical rate; mortality; and hospital stay between the early PE and delayed PE groups (p > 0.05). All patients in the PE group and conventional group with acute renal failure had significantly higher D-dimer levels than those without acute renal failure (p < 0.05). DISCUSSION: Compared with conventional treatment, PE does not have a better therapeutic effect on HTGAP. The D-dimer level can predict whether patients with HTGAP will have acute renal failure.