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Patient-reported Outcomes in Mothers with Chronic Hepatitis B Infection: A cross-sectional analysis - 25/01/25

Doi : 10.1016/j.clinre.2025.102537 
Shi OuYang 1, #, Yueying Deng 1, 2, #, Yawen Geng 3, Xiaoli Yuan 1, Tingting Peng 1, Junchao Qiu 4, Zhirong Xiao 4, Shengguang Yan 2, Haitao Deng 1, 5, Xiaotong Peng 1, 5, Calvin Q. Pan 1, 6,
1 Department of Infectious Diseases, Key Laboratory of Biological Targeting Diagnosis, Therapy, and Rehabilitation of Guangdong Higher Education Institutes, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China 
2 School of Public Health, North China University of Science and Technology, Tangshan, China 
3 Department of Gynecology and Obstetrics, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China 
4 Department of Obstetrics, Key Laboratory of Biological Targeting Diagnosis, Therapy, and Rehabilitation of Guangdong Higher Education Institutes, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. 
5 School of Public Health, Guangzhou Medical University, Guangzhou, China 
6 Division of Gastroenterology and Hepatology, Department of Medicine, NYU Langone Health, New York University Grossman School of Medicine, New York, USA 

Corresponding Author: Division of Gastroenterology, Department of Medicine, NYU Langone Medical Center, New York University School of Medicine, New York, NY, USA. Tel: +001-(718)-888-7728, Fax: +001-(718)-353-6901Division of GastroenterologyDepartment of MedicineNYU Langone Medical CenterNew York University School of MedicineNew YorkNYUSA
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Highlights

This study is the first to compare patient-reported outcomes between pregnant mothers with chronic hepatitis B (CHB) and healthy mothers.
Pregnant mothers with CHB have significantly lower health-related quality of life (HRQoL) and face greater challenges in social functioning and anxiety.
High HBV DNA levels (>200,000 IU/mL) are associated with further deterioration of HRQoL.

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Abstract

Background & Aims

The health-related quality of life (HRQoL) during pregnancy has not been well-lidated in mothers with chronic hepatitis B (CHB). We aim to compare patient-reported outcomes (PROs) in CHB mothers with those of healthy mothers during pregnancy.

Methods

Between 4/16/2023 and 7/31/2023, we invited consecutive CHB and healthy mothers to complete the self-administered 36-item Short Form Survey (SF-36) and the Chronic Liver Disease Questionnaire (CLDQ) for PRO assessment. Pairwise comparisons of PRO scores between groups were performed using chi-square tests. Covariates for worse PROs were further analyzed by the multiple linear regression model to identify the independent predictors

Results

Among 257 participants (CHB: healthy control was 100:157), the mean (SD) age was 29.6 (3.4), and the majority completed the PRO assessment at the gestational weeks of 16-24. When compared to healthy mothers, CHB mothers had a significant impairment of PROs in the CLDQ domain of worry (6.97±0.16 vs 5.83±0.99, p<0.05) and the SF-36 domain of social functioning (95.33±10.00 vs 91.67±16.37, p<0.05). The subgroup analyses in CHB mothers showed HBV DNA >200,000 IU/mL associated with significantly worse PROs. The multivariate analyses identified CHB infection, severe nausea or vomiting, poor living conditions, and spousal negative attitude as independent predictors of HRQoL impairment.

Conclusion

This study suggests that CHB infection during pregnancy negatively impacted HRQoL, particularly in worry and social functioning domains. CHB infection was an independent predictor for PRO impairments. Further integration of monitoring and intervention on HRQoL impairment should be considered when managing CHB mothers during pregnancy.

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Keywords : HBV viremia, Hepatitis B during pregnancy, Social function impairment, Chronic liver disease questionnaire, 36-item Short Form Survey


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