To investigate the influence of hepatitis B related liver cirrhosis on pregnancy complications and neonatal outcomes.

Clinical data of 55 pregnant women with hepatitis B related liver cirrhosis (research group) who delivered in Beijing Ditan Hospital, Capital Medical University from December 2008 to December 2020 were collected, while patients with chronic hepatitis B were collected as control group (55 cases) with matched age and gestational weeks. The differences of white blood cells (WBC) count, hemoglobin (Hb), red blood cell (RBC) count, alpionine aminotransferase (ALT), apartate acid transferase (AST), total bilirubin (TBil), prothrombin time (PT) and platelet (PLT) count between the two groups were analyzed, retrospectively. Pregnancy complications and neonatal adverse outcomes of the two groups were analyzed by chi-square test.

The levels of WBC count [7.95 (6.12, 9.17) × 10⁹/L vs. 6.88 (5.66, 8.05) × 10⁹/L; Z =-1.674, P = 0.095], ALT [20.10 (13.00, 36.70) U/L vs. 17.5 (13.30, 21.20) U/L; Z =-1.698, P = 0.090] and AST [25.70 (16.30, 35.10) U/L vs. 25.40 (20.80, 31.50) U/L; Z =-1.034, P = 0.303] of cases in control group and research group before pregnancy termination were all without significant differences. However, the levels of hemoglobin [120.00 (110.00, 128.00) g/L vs. 111.00 (96.60, 119.00) g/L; Z =-3.696, P < 0.001], RBC count [3.93 (3.57, 4.16) × 10⁹/L vs. 3.34 (2.97, 3.71) × 10⁹/L; Z = -5.055, P < 0.001], TBil [7.5 (5.80, 9.80) μmol/L vs. 10.00 (7.30, 14.10) μmol/L; Z =-2.816, P = 0.005], PT [10.40 (10.00, 11.10) s vs. 11.50 (10.60, 12.90) s; Z =-4.023, P < 0.001] and PLT count [172.00 (142.40, 211.00) × 10⁹/L vs. 79.2 (60.80, 140.20) × 10⁹/L; Z =-6.068, P < 0.001] between cases of the two groups were all with significant differences. The rates of pregnancy complications including gestational diabetes mellitus, gestational hypertension disease, thyroid dysfunction, amniotic fluid abnormality, premature rupture of membrane, liver function abnormality, bilirubin abnormality and intrahepatic cholestasis of pregnancy between cases of the two groups were all without significant differences (all P > 0.05). However, the incidence rates of postpartum hemorrhage [4 cases (7.27%) vs. 14 cases (25.45%); χ² = 6.643, P = 0.010], anemia associated with pregnancy [10 cases (18.18%) vs. 27 cases (49.09%); χ² = 11.770, P = 0.001], coagulation dysfunction [3 cases (5.45%) vs. 10 cases (18.18%); χ² = 4.274, P = 0.039] and cesarean section [29 cases (52.73%) vs. 46 cases (83.64%); χ² = 12.110, P = 0.001] were all with significant differences (all P < 0.05). The rates of adverse pregnancy outcomes including neonatal asphyxia [2 cases (3.64%) vs. 3 cases (5.45%); χ² = 0.000, P = 1.000], neonatal death [0 case (0.00%) vs. 2 cases (3.64%); χ² = 0.509, P = 0.405] and fetal malformation [1 case (1.82%) vs. 0 case (0.00%), P = 1.000] between newborns of the two groups were all without significant differences (all P > 0.05).

Pregnant women with hepatitis B related liver cirrhosis were at higher risk of postpartum hemorrhage, anemia and coagulation dysfunction than pregnant women with chronic hepatitis B, and the rates of cesarean section also increased. Therefore, the condition changes of pregnant women with hepatitis B related liver cirrhosis should be closely monitored during pregnancy.