Effect of invasive tests during pregnancy on perinatal transmission of hepatitis B infection: a scoping review

Summary: Prenatal and intrapartum invasive tests are possible mechanisms of mother to child transmission (MTCT) of hepatitis B virus (HBV). The viral activity can affect the MTCT risk after invasive tests, but the evidence is scarce. This scoping review discussed the effects of prenatal or intrapart...

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Main Authors: Ka Wang Cheung, Tiffany Sin-Tung Au, Ying Rong Li, Zhenyan Han, Zhu Zhang, Mimi Tin Yan Seto
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:EClinicalMedicine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2589537024006187
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author Ka Wang Cheung
Tiffany Sin-Tung Au
Ying Rong Li
Zhenyan Han
Zhu Zhang
Mimi Tin Yan Seto
author_facet Ka Wang Cheung
Tiffany Sin-Tung Au
Ying Rong Li
Zhenyan Han
Zhu Zhang
Mimi Tin Yan Seto
author_sort Ka Wang Cheung
collection DOAJ
description Summary: Prenatal and intrapartum invasive tests are possible mechanisms of mother to child transmission (MTCT) of hepatitis B virus (HBV). The viral activity can affect the MTCT risk after invasive tests, but the evidence is scarce. This scoping review discussed the effects of prenatal or intrapartum invasive tests on the risk of HBV MTCT. The risk of MTCT after amniocentesis was low among hepatitis B infected pregnant individuals with negative hepatitis B e antigen (HBeAg) statuses or HBV DNA < 7 log10 IU/mL, and comparable to those that did not undergo prenatal invasive tests. Amniocentesis could increase the risk of MTCT among women with seropositive HBeAg statuses or HBV DNA ≥ 7 log10 IU/mL, but there were no MTCT among these women who received antiviral treatment. Data on CVS, cordocentesis and intrapartum invasive tests were insufficient to conclude their effects on MTCT. We also reviewed 50 international clinical practice guidelines. Most of them did not have recommendations on the management of hepatitis B infected pregnant individuals requiring prenatal or intrapartum invasive tests and significant discrepancies existed among the remaining guidelines. A workflow and two pragmatic approaches were discussed to assist clinical management. Furthermore, we would like to encourage future research to provide comprehensive data on the factors influencing the MTCT rate (such as maternal HBV DNA viral load and HBeAg status, availability and timing of neonatal birth dose immunizations, transplacental or transamniotic invasive tests, complications of the invasive tests and the use of antiviral prophylaxis).
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spelling doaj-art-e52334f7904243dbb7012e35d194ac222025-01-14T04:12:33ZengElsevierEClinicalMedicine2589-53702025-02-0180103039Effect of invasive tests during pregnancy on perinatal transmission of hepatitis B infection: a scoping reviewKa Wang Cheung0Tiffany Sin-Tung Au1Ying Rong Li2Zhenyan Han3Zhu Zhang4Mimi Tin Yan Seto5Department of Obstetrics and Gynecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China; Corresponding author. 6/F, Professorial Block, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China.Department of Obstetrics and Gynecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, ChinaDepartment of Obstetrics and Gynecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, ChinaThird Affiliated Hospital of Sun Yat-sen University, ChinaDepartment of Medical Genetics, West China Second University Hospital, ChinaDepartment of Obstetrics and Gynecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, ChinaSummary: Prenatal and intrapartum invasive tests are possible mechanisms of mother to child transmission (MTCT) of hepatitis B virus (HBV). The viral activity can affect the MTCT risk after invasive tests, but the evidence is scarce. This scoping review discussed the effects of prenatal or intrapartum invasive tests on the risk of HBV MTCT. The risk of MTCT after amniocentesis was low among hepatitis B infected pregnant individuals with negative hepatitis B e antigen (HBeAg) statuses or HBV DNA < 7 log10 IU/mL, and comparable to those that did not undergo prenatal invasive tests. Amniocentesis could increase the risk of MTCT among women with seropositive HBeAg statuses or HBV DNA ≥ 7 log10 IU/mL, but there were no MTCT among these women who received antiviral treatment. Data on CVS, cordocentesis and intrapartum invasive tests were insufficient to conclude their effects on MTCT. We also reviewed 50 international clinical practice guidelines. Most of them did not have recommendations on the management of hepatitis B infected pregnant individuals requiring prenatal or intrapartum invasive tests and significant discrepancies existed among the remaining guidelines. A workflow and two pragmatic approaches were discussed to assist clinical management. Furthermore, we would like to encourage future research to provide comprehensive data on the factors influencing the MTCT rate (such as maternal HBV DNA viral load and HBeAg status, availability and timing of neonatal birth dose immunizations, transplacental or transamniotic invasive tests, complications of the invasive tests and the use of antiviral prophylaxis).http://www.sciencedirect.com/science/article/pii/S2589537024006187AmniocentesisChorionic villus samplingCordocentesisImmunisationImmunoprophylaxis failureScalp blood sampling
spellingShingle Ka Wang Cheung
Tiffany Sin-Tung Au
Ying Rong Li
Zhenyan Han
Zhu Zhang
Mimi Tin Yan Seto
Effect of invasive tests during pregnancy on perinatal transmission of hepatitis B infection: a scoping review
EClinicalMedicine
Amniocentesis
Chorionic villus sampling
Cordocentesis
Immunisation
Immunoprophylaxis failure
Scalp blood sampling
title Effect of invasive tests during pregnancy on perinatal transmission of hepatitis B infection: a scoping review
title_full Effect of invasive tests during pregnancy on perinatal transmission of hepatitis B infection: a scoping review
title_fullStr Effect of invasive tests during pregnancy on perinatal transmission of hepatitis B infection: a scoping review
title_full_unstemmed Effect of invasive tests during pregnancy on perinatal transmission of hepatitis B infection: a scoping review
title_short Effect of invasive tests during pregnancy on perinatal transmission of hepatitis B infection: a scoping review
title_sort effect of invasive tests during pregnancy on perinatal transmission of hepatitis b infection a scoping review
topic Amniocentesis
Chorionic villus sampling
Cordocentesis
Immunisation
Immunoprophylaxis failure
Scalp blood sampling
url http://www.sciencedirect.com/science/article/pii/S2589537024006187
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