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Objective: Pregnant hepatitis B carriers may have a higher risk of adverse pregnancy outcomes. Current evidences are conflicting regarding the relationship between hepatitis B virus (HBV) and various pregnancy complications, owing to the inclusion of women with different viral activity. This study is to evaluate the relationship between hepatitis B e antigen (HBeAg) status/HBV DNA level and pregnancy outcomes among pregnant hepatitis B carriers in Hong Kong., Materials and Methods: This was a retrospective analysis of a prospective multicenter observational study carried out in Hong Kong between 2014 and 2016. Pregnant HBV carriers were recruited. HBeAg was tested. HBV DNA level was quantified at 28-30 weeks of gestation. The rates of gestational diabetes mellitus (GDM), gestational hypertension, pre-eclampsia, preterm prelabour rupture of membranes (PPROM), preterm birth, low birth weight (LBW), macrosomia and mode of delivery were recorded., Results: 679 pregnancies were analyzed. 23.3% of women were seropositive for HBeAg. The mean viral load (SD) at 28-30 weeks of gestation was 3.6 (2.5) log 10 IU/ml. No statistically significant differences were found in the rates of GDM, gestational hypertension, pre-eclampsia, PPROM, preterm birth, LBW, macrosomia and mode of delivery among women with different viral load levels (≤2 log 10 IU/ml, 2.01-6 log 10 IU/ml and >6 log 10 IU/ml). Positive maternal HBeAg status was not associated with pregnancy complications compared to seronegative women., Conclusion: Seropositive HBeAg status or a higher level of HBV DNA during pregnancy did not pose a significant negative impact to the pregnancy outcomes., Competing Interests: Declaration of competing interest All authors have disclosed no conflicts of interest., (Copyright © 2022. Published by Elsevier B.V.)

Lack of awareness regarding the risk of hepatitis B virus (HBV) infection and the interventions available during pregnancy among the pregnant carriers may influence their willingness and adherence to the management. This study assessed the knowledge, perception and expectation of HBV infection among pregnant HBV carriers in Hong Kong. A prospective multicentre cross-sectional questionnaire study was carried out between August 2019 and April 2021. The general knowledge on HBV, perception and expectation, and interventions to reduce vertical transmission were questioned. Obtaining ≥70% correct answers was defined as having sufficient knowledge. 422 (82.7%) were known carriers. Only 18.4% of women had sufficient overall knowledge. The correct answer rates and percentage of sufficient knowledge were statistically lower for HBV knowledge specific to pregnancy compared with general knowledge (42.5% vs. 58.5%, p < 0.001; 8.8% vs. 30.2%, p < 0.001 respectively). Multiple logistic regression showed higher education and receiving HBV medical care within a year prior to pregnancy were associated with sufficient overall (OR 3.46; 95% CI 2.05-5.83 and OR 2.76; 95% CI 1.62-4.7, p < 0.001), and general knowledge (OR 2.86; 95% CI 1.81-4.51 and OR 2.14; 95% CI 1.33-3.44, p < 0.05). 298 (58.4%), 357 (70.0%) and 150 (29.4%) women believed they should receive care by obstetrician, hepatologist or general practitioner respectively. 46.9% did not want to initiate antiviral treatment due to the cost, perceived teratogenicity and maternal side effects. The knowledge of HBV among pregnant carriers in Hong Kong was poor despite the majority of them being aware of their carrier status prior to the pregnancy., (© 2021 John Wiley & Sons Ltd.)

Objective: To evaluate the effect of rupture of membranes and labour on the risk of hepatitis B virus (HBV) vertical transmission., Study Design: A prospective multicentre observational study was carried out in Hong Kong between 2014-2016. Pregnant HBV carriers were recruited. The duration of rupture of membranes, labour and mode of delivery were collected prospectively. HBV DNA was examined at 28-30 weeks of gestation. All newborns received standard HBV vaccination and immunoglobulin. Hepatitis B surface antigen of infants was tested at 9-12 months of age., Results: 641 pregnancies were recruited and analyzed. No statistically significant difference was found in gravida, parity, gestational age at delivery, mode of delivery, duration of rupture of membranes, duration of labour, preterm delivery, preterm rupture of membranes or birth weight (p > 0.05). Subgroup analysis in viral load > 7log 10 IU/ml and 8log 10 IU/ml also did not find a significant association between duration of rupture of membranes and labour with immunoprophylaxis failure., Conclusions: Duration of rupture of membranes and labour would not affect the risk of HBV vertical transmission in infants following standard HBV vaccination and hepatitis B immunoglobulin administration., (Copyright © 2018 Elsevier B.V. All rights reserved.)