A PROSPECTIVE COHORT TO EXPLORE BASELINE CHARACTERISTICS AND PREGNANCY OUTCOMES AMONG PREGNANT HBV CARRIERS AND NON-HBV CONTROLS

Background: Infection during Hepatitis-B (HBV) among expecting women is a threat to neonatal and maternal life. Objective: The objective of this research was to explore the association between maternal HBV carriers’ and outcomes of pregnancy. Methods: This prospective cohort research was carried out at Jinnah Hospital, Lahore from March 2017 to October 2018 on a total of 21004 pregnant women which included asymptomatic HBV carriers (513) and non-HBV controls (20491). Major interesting pregnancy outcomes were stillbirth, miscarriage, preterm birth (PTB), intrahepatic cholestasis of pregnancy (ICP), gestational diabetes (GDM), low birth weight (LBW), preterm premature rupture of the membrane (PPROM), Apgar Score and small for gestational age (SGA). The comparison of adverse pregnancy outcomes between non-HBV controls and asymptomatic HBV carriers was carried out through logistic regression and chi-square test. Statistically significant two-sided P-Value was (< 0.05). Results: The occurrence of stillbirth, GDM, PTB, PPROM, ICP, SGA and LBW were almost the same between both groups. Miscarriage proportion was reported 9.36% in HBV carrier and 5.7% in non-HBV groups (P-Value < 0.001). After employing multivariate modelling in order to adjust for the obstetric complications and socio-demographical variables the HBV carriers were more prone to miscarriage (Adjusted Odds Ratio 1.71, CI 95%, 1.23 – 2.38). Moreover, other neonatal and maternal outcomes of both groups were also the same. Conclusion: Maternal Hepatitis-B (HBV) carrier status may represent miscarriage. Rather it is a risk factor for miscarriage among pregnant women; therefore, careful monitoring is suggested with grave concerns for the neonatal and maternal health. Keywords: Hepatitis-B, HBV, Pregnancy, Infection, Virus, Miscarriage, Neonatal, Maternal, GDM, PTB, PPROM, ICP, SGA, LBW and Carriers