Prevalence of Hepatitis B Carrier Status and Its Negative Association with Hypertensive Disorders in Pregnancy

Abstract

Background and Objectives. To evaluate whether a negative association between chronic hepatitis B carrier status and hypertensive disorders in pregnancy could continue to be demonstrated in an endemic area with a changing prevalence for chronic hepatitis B infection. Study Design. A retrospective cohort of all deliveries in a single centre over a period of 20 years in a population with high prevalence for chronic hepatitis B carrier status was studied. Main Outcome Measures. The primary outcome was the prevalence of chronic HBV carrier status and gestational hypertensive disorders in pregnancy during the study period. The secondary outcome measures included the major risk factors for gestational hypertensive disorders. The overall association between HBV carrier status and gestational hypertensive disorders and the association with major risk factors were then evaluated. Results. In a total cohort of 87889 deliveries over a period of 20 years, the prevalence rate of HBV fell from around 10-11% to around 6-7% in the last 5 years of the study. A negative association between chronic HBV carrier status and all gestational hypertensive disorders could be demonstrated. An apparent protective effect of HBV carrier status was apparently more robust against preeclampsia than gestational hypertension, as the negative association with preeclampsia was consistently observed throughout the study period. A logistic regression model showed that advanced maternal age, multiple pregnancies, obesity, and significant medical disorders were positively correlated with gestational hypertensive disorders, while multiparity and positive HBV carrier status were negatively correlated. Conclusion. Chronic HBV carrier status appeared to have a protective effect against the development of preeclampsia and gestational hypertension in an endemic area with high HBV prevalence rates.