Maternal and infant growth outcomes following preconception antiviral therapy in chronic hepatitis B virus infection: A retrospective cohort study

Despite the clinical significance, data are limited on pregnancy outcomes and infant growth among women with chronic hepatitis B virus (HBV) infection treated with antiviral treatment before pregnancy (ATBP). This study aimed to evaluate the effects of ATBP on maternal pregnancy outcomes and infant growth parameters. A retrospective cohort study was conducted among 1031 women aged ≥20 years with singleton pregnancies and chronic HBV infection, recruited from January 2021 to January 2023. Propensity score matching was applied to balance baseline characteristics across 3 groups: 99 women receiving ATBP, 99 receiving antiviral treatment during pregnancy (ATDP), and 99 receiving no antiviral treatment. Pregnancy outcomes were analyzed using modified Poisson regression, while infant growth parameters were assessed by generalized linear regression, stratified by sex. After matching, mothers in the ATBP group exhibited a significantly lower risk of gestational abnormal alanine aminotransferase compared to those in the ATDP group. No significant differences were observed in maternal pregnancy outcomes (such as hypertensive disorders of pregnancy, gestational diabetes mellitus, and preterm birth) and in the growth parameters of their infants in the ATBP group versus the other 2 groups. Only 1 infant in this study, who was in the ATDP group and received antiviral treatment starting at 24 weeks of gestation, was diagnosed with chronic HBV infection. Our findings indicated that ATBP was associated with a lower risk of gestational alanine aminotransferase abnormalities in women with chronic HBV infection. However, we did not find a difference in maternal pregnancy outcomes or infant growth in the first year of life. These results provide insights for clinicians managing pregnancy in this population.