Maternal viral load as a risk for adverse obstetric and Perinatal outcome in chronic hepatitis b infection

Hepatitis B viral load is directly related to the risk of disease progression. Studies reporting outcomes and indication for treatment are interpreted in relation to viral load. The main objective of this study is to determine the relationship between viral load and obstetric and neonatal outcomes in hepatitis B virus (HBV) infected mothers. Two hundred and sixty two pregnant women whose HBV status was determined by PCR and HBsAg were recruited for the study. They were categorized based on their viral load; viral load > 106 copies/ml as case and < 106 copies/mlas control. Maternal and neonatal outcomes were assessed and compared between the two groups. The results revealed age, income and place of residence (whether rural or urban) were comparable between the two groups. However, there was an association between an infected mothers’ educational level and serum HBV DNA level. Parity, PIH foul smelling liquor, and previous abortion were comparable between the two groups. PROM (p<0.05) and a history of STI/UTI (p<0.05) were associated with high maternal viral load. Mothers with viral load >106 copies/ml are at higher risk for PROM. The higher the viral load the greater the risk for having neonates with birth weight <2500g (p<0.05). Being preterm, asphyxiated and low APGAR scored neonate is not directly associated with maternal viral load. Routine screening of HBV infected pregnant women for viral load will determine the need for antiviral therapy to reduce adverse perinatal outcome and MTCT.