RESUMEN
AIMS: To investigate the impact of pregnancy with combined hepatitis B virus (HBV) infection and Gestational diabetes mellitus (GDM) on fetal growth and adverse perinatal outcomes. METHODS: All the pregnant women with HBV infection and/or GDM who delivered at Women's Hospital, Zhejiang University between January 2015, and September 2022 were included. A total of 1633 pregnant women were recruited in the final analysis, including 409 women with HBV infection and GDM, 396 with HBV infection only, 430 with GDM only, and 398 without HBV infection and GDM. Linear and logistic regression models were used to study the impact of pregnancy with combined HBV infection and GDM on fetal growth and adverse perinatal outcomes. RESULTS: Pregnancy with combined HBV infection and GDM was associated with increased Z-scores on primary fetal ultrasound parameters and significantly increased the risk of fetal femur length overgrowth (OR: 2.88, 95 % CI: 1.13 â¼ 7.35), placental abruption (OR: 3.64, 95 % CI: 1.18 â¼ 11.22), and macrosomia (OR: 4.19, 95 % CI: 1.66 â¼ 10.56) compared to pregnancy without HBV infection and GDM. CONCLUSIONS: Both maternal HBV infection and GDM are independently associated with adverse perinatal outcomes. Their combination further increases the risk of adverse perinatal outcomes.
Asunto(s)
Diabetes Gestacional , Hepatitis B , Complicaciones Infecciosas del Embarazo , Embarazo , Femenino , Humanos , Virus de la Hepatitis B , Estudios Retrospectivos , Resultado del Embarazo , Placenta , Desarrollo Fetal , Hepatitis B/complicacionesRESUMEN
BACKGROUND: Placental health and serial fetal ultrasound parameters deficits in fetal development in women with psychiatric disorders have yet to be understood. This study aimed to examine the effects of psychiatric disorders on placental health, ultrasound measurements, and adverse perinatal outcomes among Chinese pregnant women. METHODS: All the pregnant women with psychiatric disorders who delivered at Women's Hospital School of Medicine, Zhejiang University, China, between 2010 and 2020 were included. A total of 992 women (716 in the healthy control group and 276 in the psychiatric disorders group) were recruited. Outcomes include maternal and neonatal birth outcomes. Linear and logistic regression models were used to determine the beta (ß) and odds ratios (OR) across 2 models after adjusting for multiple covariates. RESULTS: For women with psychiatric diagnoses, the mean placental measurements and serial fetal ultrasound parameters, and neonatal birth weight were lower than general pregnant women. After controlling the use of psychotropic medication during pregnancy, women with psychiatric diagnoses showed higher rates of placental implantation abnormalities or placental adhesion (OR = 5.724, 95% CI = [1.805, 15.408]), gestational diabetes mellitus (OR = 3.861, 95% CI = [2.109, 7.068]), anemia in pregnancy (OR = 4.944, 95% CI = [2.306, 10.598]), preterm birth <37 weeks' gestation (OR = 3.200, 95% CI = [1.702, 6.016]), low birth weight (OR = 11.299, 95% CI = [4.068, 31.386]), and neonatal intensive care unit admission (OR = 3.143, 95% CI = [1.656, 5.962]) compared to women in the healthy control group. CONCLUSION: Pregnant women with psychiatric disorders were more likely to have poor placental outcomes, more ultrasound parameter abnormalities and obstetrical complications, and a higher risk for adverse birth outcomes.