探讨乙型肝炎病毒（HBV）载量对妊娠妇女母婴结局的影响。

回顾性分析本院2010年11月至2014年12月收治的住院分娩孕妇共1 783例，其中HBV携带者631例，非HBV携带者1 152例；根据HBV DNA载量分组，HBV DNA载量≥ 1.0 × 10³ U/ml者为阳性组（281例），HBV DNA载量< 1.0 × 10³ U/ml者为阴性组（350例），同时收集无HBV携带孕妇1 152例为对照组。比较每组妊娠妇女分娩孕周、剖宫产率、住院时间、妊娠期并发症（早产、产后出血、妊娠期高血压、胎儿窘迫）以及新生儿出生体重、新生儿窒息和高胆红素血症发生情况。

各组妊娠妇女分娩周数、剖宫产率和住院时间差异均无统计学意义（F = 1.750、P = 0.175，χ²= 1.575、P = 0.230，F = 0.982、P = 0.465）；三组妊娠妇女早产发生率差异具有统计学意义（F = 10.148、P = 0.006）；阳性组患者早产发生率为8.84%，显著高于对照组（3.73%）（χ²= 13.328、P < 0.001）；三组妊娠妇女产后出血、妊娠期高血压和胎儿窘迫等发生率差异均无统计学意义（P均> 0.05）；但阳性组和阴性组妇女出血量则显著高于对照组（t = 92.823、8.714，P均< 0.001），阳性组和阴性组妇女产后出血量差异无统计学意义。三组新生儿体重差异具有统计学意义（F = 137.240、P < 0.001），而阳性组和阴性组新生儿体重显著低于对照组新生儿（t = 15.243、14.871，P均< 0.001）；三组新生儿窒息发生率差异无统计学意义（χ² = 3.185、P = 0.203）。各组新生儿高胆红素血症发生率差异具有统计学意义（χ² = 74.292、P < 0.001），进一步进组间比较发现阳性组和阴性组新生儿高胆红素血症发生率显著高于对照组（χ² = 58.949、64.060，P均< 0.001），而阳性组和阴性组新生儿高胆红素血症发生率差异无统计学意义（χ² = 0.012、P = 0.913）。

HBV DNA载量升高时，胎儿早产发生率、产妇产后出血量和新生儿高胆红素血症发生率均增加，但新生儿体重下降，而对妊娠期其他并发症无显著影响。

To investigate the effect of hepatitis B virus (HBV) DNA load on outcomes of maternal and neonatal.

The clinical data of 1 783 pregnant women were collected in our hospital from November 2010 to December 2014, including 631 cases of HBV carriers, 1 152 cases of non-HBV carriers. All cases were divided into positive group (281 cases) with HBV DNA ≥ 1.0 × 10³ U/ml and negative group (350 cases) with HBV DNA < 1.0 × 10³ U/ml, while the HBV negative pregnant women were collected as control group. The pregnant weeks of childbirth, gestational age of delivery, rate of cesarean section, days of stay in hospital, complications (such as premature delivery, postpartum hemorrhage, gestational hypertension or fetal distress), and birth weight, neonatal asphyxia, hyperbilirubinemia occurrence of newborn were compared, respectively.

There were no significant differences of pregnant weeks of childbirth, cesarean section rate and the days of stay in hospital among the three groups (F = 1.750, P = 0.175; χ² = 1.575, P = 0.230; F = 0.982, P = 0.465), but the incidences of preterm birth among the three groups were significantly different (F = 10.148, P = 0.006), and the incidence of premature delivery in the positive group was 8.84%, which was significantly higher than that of the control group (3.73%), with significant difference (χ²= 13.328, P < 0.001). There were no significant differences in the incidence of postpartum hemorrhage, pregnancy induced hypertension and fetal distress among the three groups (all P > 0.05), but the bleeding volume of patients in the positive and negative groups were significantly higher than that of the control group (t = 92.823, 8.714; all P < 0.001), but there was no significant difference in postpartum haemorrhage amount between the positive group and negative group. The neonatal weights of three groups were significantly difference (F = 137.240, P < 0.001), and the neonatal weights of the positive group and negative group were significantly lower than that of the control group (t = 15.243, 14.871; all P < 0.001). There was no significant different in the incidence of neonatal asphyxia among the three groups (χ² = 3.185, P = 0.203), the incidence of neonatal hyperbilirubinemia among the three groups were significantly different (χ² = 58.949, 64.060; all P < 0.001), which was not significantly different between positive and negative groups (χ² = 0.012, P = 0.913).

With HBV DNA load increasing, the incidence of preterm labor, maternal postpartum haemorrhage amount and neonatal hyperbilirubinemia increased, while the neonatal weight decreased and had no influence on other complications during pregnancy.