Hepatitis B virus infection and intrahepatic cholestasis of pregnancy: a birth cohort study in Lanzhou, China

Abstract

Abstract Background: Intrahepatic cholestasis of pregnancy (ICP) has been confirmed to have a clear influence on pregnancy outcome. This study is aimed at investigating the correlation between hepatitis B virus (HBV) infection and ICP, and confirming whether HBV infection may aggravate the adverse fetal or maternal outcomes of ICP. Methods: A birth cohort study was conducted from 2010–2012 at Gansu Provincial Maternity & Child Care Hospital in Lanzhou, China. A total of 10,536 pregnant women without chronic hepatopathy were enrolled. HBV infection was defined by the presence of hepatitis B virus antigens (HBsAg) positive. Results: 259 (2.46%) women were diagnosed with ICP and it was observed that maternal HBV infection increased the risk of ICP (OR:1.95, 95%CI:1.17-3.24). Compared to non-ICP with HBV negative women, ICP with HBV positive women were more likely to have postpartum hemorrhage (PPH) (p=0.019), caesarean section(p<0.0001), and preterm birth(p<0.0001). When ICP was combined with HBV infection, after adjusting for influencing factors, the risk of PPH was increased compared with ICP with HBV negative (OR: 6.65, 95%CI: 1.30-33.95), non-ICP with HBV positive (OR: 11.16, 95%CI: 1.83-68.18), or non-ICP with HBV negative (OR: 10.12, 95%CI: 2.72-37.67). Conclusions: Our study supports the hypothesis that HBV infection increases the risk of ICP. Furthermore, it indicates that ICP combined with HBV infection substantially increases PPH risk.