Impact of maternal hepatitis B carrier status on congenital abnormalities: a systematic review and meta-analysis

Objectives This study aims to explore whether maternal hepatitis B carrier status is associated with an increased risk of congenital abnormalities.Design A systematic review and meta-analysis of observational studies.Data sources PubMed, Embase (Ovid), Scopus, the China National Knowledge Infrastruc...

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Main Authors: Jing Wang, Xin Sun, Jing Tan, Kang Zou, Shiyao Huang, Chunrong Liu, Yana Qi, Yiquan Xiong
Format: Article
Language:English
Published: BMJ Publishing Group 2023-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/3/e066017.full
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author Jing Wang
Xin Sun
Jing Tan
Kang Zou
Shiyao Huang
Chunrong Liu
Yana Qi
Yiquan Xiong
author_facet Jing Wang
Xin Sun
Jing Tan
Kang Zou
Shiyao Huang
Chunrong Liu
Yana Qi
Yiquan Xiong
author_sort Jing Wang
collection DOAJ
description Objectives This study aims to explore whether maternal hepatitis B carrier status is associated with an increased risk of congenital abnormalities.Design A systematic review and meta-analysis of observational studies.Data sources PubMed, Embase (Ovid), Scopus, the China National Knowledge Infrastructure (CNKI) and the Wanfang databases.Study selection Five databases were searched systematically from inception to 7 September 2021. Cohort and case–control studies that investigated the association between maternal hepatitis B virus (HBV) infection and congenital abnormalities were included. This study was conducted according to MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines.Data extraction and synthesis Two reviewers independently collected data, as well as assessed risk of bias by using Newcastle–Ottawa Scale. We pooled crude relative risk (cRR) and adjusted OR (aOR) by DerSimonian-Laird random-effects model. Heterogeneity was explored by I2 statistics, Cochran’s Q test. Several subgroup analyses and sensitivity analyses were performed.Results In total, 14 studies involving 16 205 pregnant women exposed to HBV were included. The pooled cRR of 1.15 (95% CI: 0.92 to 1.45; 14 studies included) showed a marginal but not significant association between maternal HBV-carrier status and congenital abnormalities. However, the pooled aOR of 1.40 (95% CI: 1.01 to 1.93; 8 studies included) indicated that pregnant women with HBV infection might be associated with a higher risk of congenital abnormalities. Subgroup analyses of adjusted data showed a higher pooling cRR or aOR on high prevalence HBV infection populations, as well as studies from Asia and Oceania.Conclusions Maternal hepatitis B carrier status might be at potential risk for congenital abnormalities. The existing evidence was not sufficient to draw a firm conclusion. Additional studies may be warranted to confirm the association.PROSPERO registration number CRD42020205459.
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spelling doaj.art-2fb5694ab957408fa27306959ae7817d2023-08-11T11:30:07ZengBMJ Publishing GroupBMJ Open2044-60552023-03-0113310.1136/bmjopen-2022-066017Impact of maternal hepatitis B carrier status on congenital abnormalities: a systematic review and meta-analysisJing Wang0Xin Sun1Jing Tan2Kang Zou3Shiyao Huang4Chunrong Liu5Yana Qi6Yiquan Xiong76Inner Mongolia Institute of Digestive Diseases, The Second Affiliated Hospital of Baotou Medical College, Baotou, ChinaInstitute of Integrated Traditional Chinese and Western Medicine, Chinese Evidence-based Medicine Center, and MAGIC China Center, West China Hospital, Sichuan University, Chengdu, ChinaNMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, Sichuan, ChinaInstitute of Integrated Traditional Chinese and Western Medicine, Chinese Evidence-based Medicine Center, and MAGIC China Center, West China Hospital, Sichuan University, Chengdu, ChinaChinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaChinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaChinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaChinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaObjectives This study aims to explore whether maternal hepatitis B carrier status is associated with an increased risk of congenital abnormalities.Design A systematic review and meta-analysis of observational studies.Data sources PubMed, Embase (Ovid), Scopus, the China National Knowledge Infrastructure (CNKI) and the Wanfang databases.Study selection Five databases were searched systematically from inception to 7 September 2021. Cohort and case–control studies that investigated the association between maternal hepatitis B virus (HBV) infection and congenital abnormalities were included. This study was conducted according to MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines.Data extraction and synthesis Two reviewers independently collected data, as well as assessed risk of bias by using Newcastle–Ottawa Scale. We pooled crude relative risk (cRR) and adjusted OR (aOR) by DerSimonian-Laird random-effects model. Heterogeneity was explored by I2 statistics, Cochran’s Q test. Several subgroup analyses and sensitivity analyses were performed.Results In total, 14 studies involving 16 205 pregnant women exposed to HBV were included. The pooled cRR of 1.15 (95% CI: 0.92 to 1.45; 14 studies included) showed a marginal but not significant association between maternal HBV-carrier status and congenital abnormalities. However, the pooled aOR of 1.40 (95% CI: 1.01 to 1.93; 8 studies included) indicated that pregnant women with HBV infection might be associated with a higher risk of congenital abnormalities. Subgroup analyses of adjusted data showed a higher pooling cRR or aOR on high prevalence HBV infection populations, as well as studies from Asia and Oceania.Conclusions Maternal hepatitis B carrier status might be at potential risk for congenital abnormalities. The existing evidence was not sufficient to draw a firm conclusion. Additional studies may be warranted to confirm the association.PROSPERO registration number CRD42020205459.https://bmjopen.bmj.com/content/13/3/e066017.full
spellingShingle Jing Wang
Xin Sun
Jing Tan
Kang Zou
Shiyao Huang
Chunrong Liu
Yana Qi
Yiquan Xiong
Impact of maternal hepatitis B carrier status on congenital abnormalities: a systematic review and meta-analysis
BMJ Open
title Impact of maternal hepatitis B carrier status on congenital abnormalities: a systematic review and meta-analysis
title_full Impact of maternal hepatitis B carrier status on congenital abnormalities: a systematic review and meta-analysis
title_fullStr Impact of maternal hepatitis B carrier status on congenital abnormalities: a systematic review and meta-analysis
title_full_unstemmed Impact of maternal hepatitis B carrier status on congenital abnormalities: a systematic review and meta-analysis
title_short Impact of maternal hepatitis B carrier status on congenital abnormalities: a systematic review and meta-analysis
title_sort impact of maternal hepatitis b carrier status on congenital abnormalities a systematic review and meta analysis
url https://bmjopen.bmj.com/content/13/3/e066017.full
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