摘要
目的:观察乙型肝炎病毒(Hepatitis B virus,HBV)感染对自然妊娠孕妇孕期并发症及新生儿的影响。方法:回顾性选取2022年1月至2023年6月于我院产科接受定期产检及分娩的75例自然妊娠孕妇合并HBV感染的临床资料,根据肝功能(血清丙氨酸氨基转移酶(Alanine aminotransferase,ALT)水平)分为异常组(ALT>40 U·L^(-1))36例及正常组(ALT≤40 U·L^(-1))39例,并选择同期正常孕妇37例为对照组。比较三组孕妇孕期、产时及产后并发症和新生儿不良结局。结果:自然妊娠合并HBV感染孕产妇中,肝功能异常39例。异常组孕妇孕期间妊娠期高血压(Pregnancy hypertension,PIH)、肝内胆汁淤积症(Intrahepatic cholestasis,ICP)、妊娠期糖尿病(Gestational diabetes mellitus,GDM)并发症率>正常组>对照组,比较有显著差异(P<0.05)。异常组孕妇产时及产后并发症有胎膜早破、宫内感染、宫内窘迫以及产后大出血,发生率异常组>正常组>对照组(P<0.05)。新生儿不良结局如早产儿、新生儿窒息、死胎以及低体质量儿发生率>正常组>对照组(P<0.05)。结论:HBV感染可影响自然妊娠孕妇肝功能,且孕妇HBV感染肝功能异常者可引起孕妇孕期PIH、ICP、GDM并发症,孕妇产时及产后胎膜早破、宫内感染、宫内窘迫以及产后大出血等并发症发生率和早产儿、新生儿窒息、死亡以及低体质量儿不良围产结局,对母婴损害较大,应在孕期加强肝功能监测,积极进行预防治疗。
Objective:To observe the impact of hepatitis B virus(HBV)infection on the complications of natural pregnancy in pregnant women and newborns.Method:A retrospective study was conducted on the clinical data of 75 natural pregnant women with HBV infection who underwent regular prenatal examination and delivery in our hospital's obstetrics from January 2022 to June 2023.They were divided into an abnormal group(serum alanine aminotransferase(ALT)>40 U·L^(-1) indicating abnormal liver function)and a normal group(ALT≤40 U·L^(-1) indicating normal liver function)based on whether liver function was normal.37 normal pregnant women during the same period were selected as the control group.Comparison of maternal pregnancy,labor and postnatal complications and adverse postnatal neonatal outcomes among the three groups.Result:There were 39 cases of abnormal liver function in natural pregnancy combined with HBV infected pregnant women.The complication rates of pregnancy hypertension(PIH),intrahepatic cholestasis(ICP),and gestational diabetes mellitus(GDM)during pregnancy in the abnormal group of pregnant women(P<0.05).Intrapartum and postpartum complications such as premature rupture of membranes,intrauterine infection,intrauterine distress and postpartum haemorrhage in pregnant women in the abnormal group>normal group>control group(P<0.05).The incidence of adverse neonatal outcomes such as preterm birth,neonatal asphyxia,stillbirth and low body mass babies was higher in the normal group than in the control group(P<0.05).Conclusion:HBV infection can affect the liver function of pregnant women in natural pregnancy,and the abnormal liver function of pregnant women with HBV infection can cause complications such as PIH,ICP,GDM,and the incidence of complications such as premature rupture of membranes,intrauterine infections,intrauterine distress,and post-partum haemorrhage,as well as adverse perinatal outcomes such as preterm birth,neonatal asphyxia,death,and low-body-quality babies,which are detrimental to both mothers and infants,and the monitoring of liver function should be strengthened and the preventive treatment should be carried out actively in the course of pregnancy.
作者
周志英
陈金玲
车志凤
Zhou Zhi-ying;Chen Jin-ling;Che Zhi-feng(Department of Laboratory,Guixi People's Hospital,Guixi 335400,Jiangxi,China)
出处
《四川生理科学杂志》
2023年第11期2069-2071,2096,共4页
Sichuan Journal of Physiological Sciences
关键词
乙型肝炎病毒
自然妊娠
孕妇
并发症
新生儿
Hepatitis B virus
Natural pregnancy
Pregnant women
Complications
neonate
