Gülenay GENÇOSMANOĞLU, Selahattin VURAL, Oğuz ÖZDEMİR, Tuğçe TUNÇ, Gürcan AKGÜL, Ayşegül ZENCİROĞLU

Gebelikte Hepatit B Taşıyıcılığının obstetrik sonuçlara etkisi

Giriş: B hepatiti dünya çapında en sık görülen enfeksiyöz hastalıklardandır. Viral bulaşın önemli bir kısmı anneden bebeğe geçiş şeklinde olmaktadır. Bazı çalışmalarda maternal-fetal bulaş dışında gebelikte gestasyonel diyabet (GDM), gebeliğin hipertansif hastalıkları, preterm doğum ve haftasına göre düşük doğum ağırlığı (DDA) gibi olumsuz gebelik sonuçları daha sık gözlenmiştir. Amaç: Gebelikte Hepatit B taşıyıcılığının maternal veya fetal kötü obstetrik sonuçları (gestasyonel diyabet, gebeliğin hipertansif hastalıkları, preterm doğum, düşük doğum ağırlığı, gebelik kolestazı) arttırması ile ilgili yapılan çalışmalarda literatürde görüş birliği bulunmamaktadır. Biz bu çalışmada hepatit B taşıyıcılığının gebelik ve perinatal sonuçlar üzerine etkisini araştırmayı planladık Gereç ve Yöntem: Bu retrospektif kohort araştırmaya çalışma grubu olarak Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı Hastalıkları Eğitim ve Araştırma Hastanesi Kadın Doğum Kliniği’nde 2009-2019 yılları arasında takipleri yapılan ve sonrasında doğumları gerçekleşen hepatit B taşıyıcısı gebeler dahil edildi. Gestasyonel diyabet, gebeliğin hipertansif hastalıkları, preterm doğum, düşük doğum ağırlığı, gebelik kolestazı riski hepatit B negatif olan kontrol grubu ile karşılaştırldı. Bulgular: Çalışmamıza 237 HBsAg pozitf , 260 kontrol olmak üzere 497 hasta dahil edildi. Kontrol grubu ile çalışma grubu arasında demografik karakterlerden yaş, gravida, parite ve VKİ açısından istatistiksel fark saptanmadı. Her iki grupta obstetrik ve perinatal sonuçlar arasında istatistiksel fark tespit edilemedi Sonuç: Hepatit B taşıyıcısı gebelerde kötü obstetrik sonuçlarda artış tespit edilmemiştir; ancak bu konuda daha büyük randomize prospektif çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler:

gebelik, hepatit b, obstetrik sonuçlar

hepatitis b carriage during pregnancy and obstetric outcomes

Introduction: B hepatitis is one of the most common infectious diseases worldwide. An important part of viral transmission occurs from mother to baby. In some studies, other than maternal-fetal transmission, adverse pregnancy outcomes such as gestational diabetes (GDM), hypertensive diseases of pregnancy, preterm birth and low birth weight (LBW) were observed more frequently. Aim: There is no consensus in the literature whether there is a relationship between adverse obstetric outcomes including gestational diabetes, hypertensive diseases of pregnancy, preterm birth, low birth weight, obstetric cholestasis and hepatitis B carriage during pregnancy . In this study, we planned to investigate the effect of hepatitis B carriage on pregnancy and perinatal outcomes Material-method: This retrospective cohort study was conducted in Dr. Sami Ulus Obstetrics and Gynecology, Pediatric Health and Disease Training and Research Hospital. Hepatitis B antigen positive pregnant women who gave birth in our hospital between years of 2009-2019 were included in our study. The risk of gestational diabetes, hypertensive diseases of pregnancy, preterm birth, low birth weight, obstetric cholestasis was compared with the hepatitis B negative pregnant women as control group. Results: Our study included 497 patients, 237 HBsAg positive pregnants and 260 healthy controls. There was no statistical difference between the control group and the study group in terms of demographic characters, age, gravida, parity and BMI. There was no statistical difference between obstetric and perinatal outcomes in both groups Conclusion: Hepatitis B carriage during pregnancy is not associated with adverse obstetric outcomes. However, larger randomized prospective studies are needed on this subject.

Keywords:

pregnancy, hepatitis b, obstetric outcome,

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