HBsAg-Positive Status, Excessive Gestational Weight Gain Risk Factors for Gestational Diabetes Mellitus

Pregnant women who are positive for hepatitis B surface antigen are at an increased risk of gestational diabetes mellitus, according to new research.

A team, led by Wanchang Yin, Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, identified the association between gestational weight gain (GWG) and gestational diabetes mellitus in HBsAg-positive women to provide management advice on gestational weight gain.

The Risk

Pregnant women with chronic HBV infections have a higher risk of developing gestational diabetes mellitus.

In the retrospective cohort, the investigators examined 39,539 pregnant women who gave birth at the Third Affiliated Hospital of Guangzhou Medical University in China.

The patients were split up into a group of HBsAG-negative (n = 36,500) and HBsAg-positive (n = 3039) groups. The investigators used univariate and multivariable logistic regression analyses to explore the link between gestational weight gain and gestational diabetes mellitus in maternal carrier women with HBV.

Results

The results show being HBsAg-positive and excessive gestational weight gain are independent risk factors for gestational diabetes mellitus, while excessive gestational weight gain was linked to a higher risk of gestational diabetes mellitus in HBsAg-positive women.

However, HBsAg-positive women with adequate gestational weight again among pre-pregnancy normal-weight women had a higher risk of gestational diabetes mellitus than HBs-Ag-negative women.Moreover, HBsAg-positive women with inadequate gestational weight gain had a lower risk of gestational diabetes mellitus.

“The optimal GWG ranges for pre-pregnancy normal-weight HBsAg-positive pregnancies might be lower than the United States Institute of Medicine recommendations,” the authors wrote. “HBsAg-positive women should strictly control GWG to reduce the risk of GDM.”

HCV Risk Factors

Earlier this year, investigators have identified at least 2 new risk factors for liver-related mortality in patients with hepatitis C virus (HCV).

A team, led by Nobuhiro Hattori, Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University School of Medicine, identified the risk factors linked to liver-related and non-liver-related mortality in patients with HCV following sustained virologic response to direct-acting antiviral agents.

In the retrospective, single-center cohort, the investigators examined 330 patients with HCV cured by DAAs. There was a median follow-up of 3.38 years. Each patient was administered IFN-free DAA treatment between September 2014 and January 2021 at the St. Marianna University Hospital. In addition, the patients with a history of hepatocellular carcinoma (HCC) did not have active HCC at the time of initiation of their final DAA therapy.

The results show a cumulative liver-related or non-liver-related mortality rate of 0.00 or 1.29% at year 1, compared to 2.87 or 3.60% at year 3 and 5.10 or 9.46% at year 5.

For liver-related deaths, 90% (n = 9) were from liver cancer, while the most common cause of non-liver-related deaths was malignancy.

After conducting a multivariate analysis using the Cox proportional hazard model, the investigators found diabetes mellitus (HR, 13.1; 95% CI, 2.81–61.3) and a history of hepatocellular carcinoma (HR, 12.8; 95% CI, 2.76–59.2), independently predicted liver-related death. There were no variables linked to non-liver-related death.

The study, “Reducing the risk of gestational diabetes mellitus in chronic hepatitis B virus carriers via more strict control of gestational weight gain,” was published online in the International Journal of Gynecology & Obstetrics.