关键词: 妊娠, 乙型肝炎病毒, 乙型肝炎表面抗原

Abstract: Objective To analyze the clinical characteristics and risk factors of hepatitis B virus (HBV) reactivation in women with non-active hepatitis B virus surface antigen (HBsAg) during and after pregnancy. 
Methods In total, 116 pregnant women who were non-active HBV carriers were retrospectively selected. Baseline data of HBV reactivation during pregnancy and non-HBV reactivation during pregnancy were analyzed to construct a clinical prediction model of baseline data and evaluate the scientificity of the model. The levels of liver function, immune function, liver fibrosis indexes and inflammatory factors during HBV activation were analyzed in pregnant women with HBV reactivation during pregnancy, after pregnancy as well as during pregnancy and after pregnancy. In the meantime, the factors influencing HBV reactivation during pregnancy on all-cause postpartum HBV reactivation was evaluated. 
Results Baseline HBV deoxyribonucleic acid (DNA) level, total cholesterol (TC), low density lipoprotein (LDL), and proportion of primipara in HBV reactivation during pregnancy group were significantly higher than those in non-HBV reactivation during pregnancy group, while age and family monthly income level were significantly lower than those in non-HBV reactivation during pregnancy group. Most HBV reactivation patients during pregnancy were primiparas (χ2/t=7.004, 5.934, 4.805, 3.853, 10.561, 7.289, P＜0.05). Baseline HBV DNA level, age and monthly family income had certain predictive value for HBV reactivation during pregnancy (cindex=0.653, AUC five month=0.679, AUC ten month=0.742, P＜0.05). HBV DNA levels, serum hyaluronic acid, laminin, N-terminal peptide of type Ⅲ procollagen, type Ⅳ collagen, C-reactive protein, interleukin-6, and tumor necrosis factor α in HBV reactivation during pregnancy group than in HBV reactivation after pregnancy group, while the levels of CD4+, CD4+/CD8+ in pregnant HBV reactivation group were significantly higher than those in HBV reactivation after pregnancy group and those in HBV reactivation during and after pregnancy group (F=5.123, 4.835, 5.035, 17.329, 14.924, 16.392, 14.320, 7.852, 14.824, 6.392, P＜0.05). All-cause HBV reactivation was more likely to occur in younger pregnant women (P＜0.05). 
Conclusion Patients with younger age, higher baseline HBV DNA level and lower monthly family income are prone to HBV reactivation during pregnancy, and the immune damage caused by HBV reactivation after pregnancy may be more serious than that during pregnancy, and all-cause HBV reactivation after childbirth is more likely to occur in younger patients. 

Key words: pregnancy, hepatitis B virus, hepatitis B surface antigens