Breastfeeding
Effects of different feeding patterns on mother-to-child transmission of HBV infections in pregnant women with high viral loads after antiviral medication during pregnancy: A prospective cohort study
Tian Ruihua, Li Xingming, Li Gaofei, Li Qiuyun, Zhang Yuzhen, Lyu Jing, Xu Biyun, Huang Yanxiang, Chen Junmei, Zhu Yunxia, Zhou Yihua
Published 2021-07-16
Cite as Chin J Perinat Med, 2021, 24(7): 497-502. DOI: 10.3760/cma.j.cn113903-20210323-00250
Abstract
ObjectiveTo study the influence of different feeding patterns on mother-to-child transmission (MTCT) of hepatitis B virus (HBV) in pregnant women with high viral loads who received antiviral medication during pregnancy to the day of delivery.
MethodsThis prospective cohort study was conducted in Beijing You'an Hospital. From January 1, 2019, to March 31, 2020, and 574 pregnant women with positive hepatitis B surface antigen (HBsAg) and HBV DNA>2×105 IU/ml were enrolled. All participants received tenofovir, telbivudine, lamivudine, or propofol tenofovir from 24-28 weeks of gestation and discontinued on the day of delivery, and their neonates were postnatally given routine passive-active immunoprophylaxis. Based on the feeding patterns, the subjects were divided into three groups: breastfeeding (n=257), bottle-feeding (n=241) and mixed feeding groups (n=76). The follow-up data were obtained from liver functions and HBV DNA level of the mothers at 6-8 weeks postpartum and HBV serological markers of infants at 7-12 months. One-way ANOVA, Student-Newman-Keuls, Chi-square test or Fisher exact test, and repeated measures ANOVA were used to analyze the data.
ResultsThe average maternal HBV DNA levels before antiviral treatment did not differ significantly between the three groups [(7.90±0.67), (7.82±0.70), (7.83±0.70) log10 IU/ml, F=0.912, P>0.05]. HBV DNA level before delivery in the mixed feeding group was slightly lower than that in the breastfeeding and bottle-feeding group [(3.87 ±1.08) vs (4.21±1.17) and (4.30±1.28) log10 IU/ml, q= 3.052 and 3.831, both P<0.05], while the comparison between the latter two groups showed no significant differences (P>0.05). After delivery, HBV DNA level in the bottle-feeding group was slightly lower than that in the breastfeeding group [(7.42±0.93) vs (7.69±0.90) log10 IU/ml, q=4.583, P<0.05]. Among 580 infants (including six pairs of twins), only one bottle-fed infant (0.4%, 1/243) was infected with HBV through MTCT, and none in the breastfeeding or mixed feeding group (P=0.553).
ConclusionsFor pregnant women with high viral loads of HBV who have received antiviral medication during pregnancy, although HBV DNA level will rebound after discontinuation upon delivery, breastfeeding is recommended considering it does not increase the risk of MTCT.
Key words:
Pregnant women; High viral loads of hepatitis B virus; Antiviral agents; Feeding mode; Mother-to-child transmission
Contributor Information
Tian Ruihua
Department of Obstetrics, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
Li Xingming
School of Public Health, Capital Medical University, Beijing 100069, China
Li Gaofei
Department of Obstetrics, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
Li Qiuyun
Department of Obstetrics, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
Zhang Yuzhen
Department of Obstetrics, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
Lyu Jing
Department of Obstetrics, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
Xu Biyun
Department of Biostatistics, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
Huang Yanxiang
Center of Clinical Laboratory, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
Chen Junmei
Center of Clinical Laboratory, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
Zhu Yunxia
Department of Obstetrics, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
Zhou Yihua
Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
