Association between maternal hepatitis B virus carrier and gestational diabetes mellitus: a retrospective cohort analysis.

INTRODUCTION: Given that many pregnant women have chronic hepatitis B virus (HBV) infection and that gestational diabetes mellitus (GDM) is linked to poor maternal and neonatal outcomes, we looked into the relationship between the hepatitis B surface antigen (HBsAg) and GDM to see if a high HBV DNA load is linked to a higher risk of GDM in chronic maternal HBsAg carriers. MATERIALS AND METHODS: Our study included 39,539 pregnant women who gave birth at the Third Affiliated Hospital of Guangzhou Medical University in Guangzhou, China, between January 1, 2009, and December 31, 2019. The patients were divided into two groups: HBsAg negative (36,500) and positive (3039). The viral load levels of 1250 HBsAg-positive women who had tested their HBV DNA load during pregnancy were separated into three groups. We utilized univariate and multivariable logistical regression analysis to determine the relationship between maternal chronic HBsAg carrier and GDM. RESULTS: Being HBsAg positive was discovered to be an independent risk factor for GDM.Pre-pregnancy Obesity and advanced age were linked to an increased incidence of GDM. Those with a high HBV DNA load (> 106 IU/mL) had a higher risk of GDM than HBsAg-positive women with a low viral load (< 103 IU/mL). Pre-eclampsia and intrahepatic cholestasis of pregnancy (ICP) appeared to be more common in HBsAg-positive women than in uninfected women. CONCLUSIONS: Being HBsAg positive, advanced age, and pre-pregnancy obesity were all revealed to be independent risk factors for GDM in our study. In HBsAg carrier, pregnant women, a high HBV DNA burden was linked to a greater risk of GDM. Furthermore, being an HBsAg carrier during pregnancy raised the risk of ICP and pre-eclampsia.

Reducing the risk of gestational diabetes mellitus in chronic hepatitis B virus carriers via more strict control of gestational weight gain.

OBJECTIVE: To explore the association between gestational weight gain (GWG) and gestational diabetes mellitus (GDM) in hepatitis B surface antigen (HBsAg) -positive women using a retrospective cohort study to provide advice on the management of GWG. METHODS: Our study included 39 539 pregnant women who gave birth at the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. Patients were divided into two groups: the HBsAg-negative and HBsAg-positive groups, comprising 36 500 and 3039 participants, respectively. We used univariate and multivariable logistic regression analyses to explore the association between GWG and GDM in maternal hepatitis B virus (HBV) carrier women. RESULTS: Being HBsAg positive and excessive GWG were independent risk factors for GDM. Excessive GWG was associated with a higher risk of GDM in HBsAg-positive women. Among pre-pregnancy women of normal weight, HBsAg-positive women with adequate GWG had a higher risk of GDM than HBsAg-negative women, whereas HBsAg-positive women with inadequate GWG had a lower risk of GDM. CONCLUSIONS: The optimal GWG ranges for pre-pregnancy normal-weight HBsAg-positive pregnancies might be lower than the US Institute of Medicine recommendations. HBsAg-positive women should strictly control GWG to reduce the risk of GDM.