Importance of maternal and cord blood viremia in pregnant women with chronic hepatitis B virus infection.

BACKGROUND/AIM: The spontaneous preterm birth (SPB) rates in a group of HBeAg-negative chronic HBV infected pregnant women without several known risk factors for preterm delivery as well as the mother to infant HBV transmission rates was evaluated. Moreover the role of maternal data during perinatal period as well as the role of HBsAg and/or HBV-DNA presence in cord blood in respect to preterm labour and vertical transmission of the infection was examined. METHODS: 138 consecutive chronic HBV infected pregnant women were haematologically, serologically and virologically evaluated during the perinatal period. 102 women were finally evaluated and fifteen of them (14.7%) exhibited SPB. Overall, 44 infants who had completed the proposed vaccination schedule were evaluated at month 12 of their life. RESULTS: A significant association between SPB and HBV-DNA presence in cord blood was observed (p=0.007). HBV-DNA positivity in cord blood was significantly associated with maternal HBV-DNA levels (p=0.002). The relative risk of HBV-DNA presence in cord blood was 6.43 times higher among women with serum HBV-DNA ≥ 10.000 copies/ml and lymphocyte count<1500 compared to those with all the other combinations of both parameters (p=0.001). All infants evaluated at month 12 were HBsAg-negative and exhibited undetectable HBV-DNA levels. CONCLUSION: The presence of HBV-DNA in cord blood is significantly associated with SPB in chronic HBV infected pregnant women. Maternal or cord blood viremia does not pose an additional risk factor for vertical transmission of HBV infection, in passive-active immunoprotected infants from HBeAg-negative chronic HBV infected mothers.

Presence of HBV-DNA in cord blood is associated with spontaneous preterm birth in pregnant women with HBeAg-negative chronic hepatitis B virus infection.

Spontaneous preterm birth is the leading cause of perinatal morbidity and mortality. In this study the spontaneous preterm birth rates in a group of hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV)-infected pregnant women without known risk factors for preterm delivery as well as the role of maternal laboratory data and hepatitis B surface antigen/HBV deoxyribonucleic acid (HBV-DNA) in cord blood in respect to preterm labour were evaluated. 138 consecutive HBeAg-negative chronic HBV-infected pregnant women were evaluated during the perinatal period. Serum HBV-DNA was determined by using the Cobas Amplicor HBV Test in both maternal and cord blood samples. 102 women were finally evaluated (36 were excluded) and 15 of them (14.7%) had spontaneous preterm birth. A significant association between spontaneous preterm birth and HBV-DNA in cord blood was observed (p = 0.007). HBV-DNA positivity in cord blood was significantly associated with maternal HBV-DNA levels (p = 0.002). The relative risk of HBV-DNA in cord blood was 6.43 times higher among women with serum HBV-DNA ≥10,000 copies/ml and lymphocyte count <1,500 compared to those with all the other combinations of both parameters (p = 0.001). In conclusion, the presence of HBV-DNA in cord blood is significantly associated with spontaneous preterm birth in chronic HBV-infected pregnant women. Women with HBV-DNA ≥10,000 copies/ml and lymphocyte count <1,500 during the perinatal period have a higher probability of HBV-DNA in their cord blood.