Prevalence and epidemiological profile of Hepatitis B in pregnant women: a population study in a Brazilian Western Amazon city from 2007 to 2015

Sanson, Marina Cordeiro Gomes; Feitoza, Helena Albuquerque Catão; Saraceni, Valeria; Koifman, Rosalina Jorge; Bessa, Andrea Ramos da Silva

doi:10.1590/1806-93042018000400003

Acessibilidade / Reportar erro

Brasil

Revista Brasileira de Saúde Materno Infantil

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLES • Rev. Bras. Saude Mater. Infant. 18 (4) • Oct-Dec 2018 • https://doi.org/10.1590/1806-93042018000400003 copy

Prevalence and epidemiological profile of Hepatitis B in pregnant women: a population study in a Brazilian Western Amazon city from 2007 to 2015

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives:

this study aimed to describe the epidemiological profile and prevalence of hepatitis B infection in pregnant women living in Rio Branco, Acre, Brazil.

Methods:

this was a cross-sectional study concerning the prevalence of Hepatitis B in a cohort of women who gave birth in Rio Branco from 2007 to 2015. Data were obtained through health information systems. Pregnant women presenting one or more serological markers or positive molecular biology examination were considered confirmed cases of infections. Infection prevalence, the odds ratio (5% significance) and sociodemographic, clinical, obstetric and neonatal variable frequency distributions were calculated. The student's t-test and Mann Whitney test were applied, as well as the chi-square test or Fisher's exact test, at a significance level of 5%.

Results:

a total of 62,100 pregnant women were identified for the study period. The prevalence of Hepatitis B in the group was of 0.38% (206 cases), and only 12,5% were diagnosed during the first gestation trimester. A significant difference (p=0.034) in the mean age of infected women was observed when compared to those without infection. The chance of an infected pregnant woman giving birth to a child with a 1st Apgar minute <7 was of 2.01 (CI95%= 1.09-3.71; p=0.995), higher than observed for healthy pregnant woman. Concerning infected patients, the most reported risk exposure was dental treatment (19.2%).

Conclusions:

the prevalence of Hepatitis B among pregnant women was lower than reported in other national studies. Low Hepatitis B detection during the first gestation trimester was identified, which reinforces the need to intensify early diagnosis during prenatal follow-up, especially due to the severity of the disease and the possibility of vertical transmission.

Key words
Health profile; Pregnancy; Hepatitis; Disease notification

Variable	HBV carrier				OR (CI95%)	p
	No (61,896)		Yes (206)
	n	%	n	%
Mother age^* * no information <5%; (years)						0.128
<25	31,834	99.7	95	0.3	1
>25	30,020	99.6	111	0.4	1.23 (0.94-1.63)
Marital status^* * no information <5%;						0.986
With partner	48,197	99.7	162	0.3	1
Without partner	12,457	99.7	42	0.3	1.00 (0.71-1.40)
Mother schooling^* * no information <5%; (years)						0.713
>8	49,815	99.7	165	0.3	1
<8	11,027	99.6	39	0.4	1.07 (0.75-1.51)
Number of prenatal consultations						0.156
<6	60,669	99.7	205	0.3	4.15 (0.58-29.60)
>6	1,227	99.9	1	0.1	1
Type of delivery^* * no information <5%;						0.402
Vaginal	34,685	99.6	122	0.4	1
Cesarean	26,900	99.7	84	0.3	0.89 (0.67-1.17)
Place of birth ^* * no information <5%;						0.738
Hospital	61,676	99.7	205	0.3	1
Other	215	99.5)	1	0.5	1.40 (0.19-10.03)
Newborn sex ^* * no information <5%;						0.605
Female	30,194	99.7	97	0.3	1
Male	31,686	99.7	109	0.3	0.93 (0.71-1.22)
Congenital anomaly detected ^ no information 10-20%; HBV = hepatitis B virus.						0.085
Yes	189	99.0	2	1.0	3.42 (0.84-13.90)
No	51,735	99.7	160	0.3	1
Low weight at birth ^* * no information <5%;						0.597
Yes	5,449	99.7	16	0.3	0.87 (0.52-1.45)
No	56,075	99.7	189	0.3	1
1^st minute Apgar ^ no information 10-20%; HBV = hepatitis B virus.						0.995
0 to 6	1,723	99.4	11	0.6	2.01 (1.09-3.71)
7 to 10	50,396	99.7	160	0.3	1
5^th minute Apgar ^ no information 10-20%; HBV = hepatitis B virus.						0.995
0 to 6	290	100.0	0	-	0.00
7 to 10	51,827	99.7	171	0.3

Variables	Hepatitis B
Variables	N	%
Gestation trimester notification
1^st trimester	30	12.5
2^nd trimester	80	33.5
3^rd trimester	103	43.1
Ignored gestational age	26	10.9
Vaccine scheme for hepatitis B
Complete	37	20.6
Incomplete	36	20.0
Not vaccinated	107	59.4
No information	59	24.7
Anti-HBS
Reactive/Positive	2	0.8
Non-reactive/Negative	59	24.7
Not performed	178	74.5
HBsAg
Non-reactive/Negative		-
Reactive/Positive	239	100.0
Not performed	0	-
HBeAg
Reactive/Positive	19	7.9
Non-reactive/Negative	152	63.6
Not performed	68	28.5
Anti-HBc Igm
Reactive/Positive	3	1.3
Non-reactive/Negative	88	36.8
Not performed	148	61.9
Anti-HBc Total
Reactive/Positive	219	91.6
Non-reactive/Negative	3	1.3
Not performed	17	7.1
Method for final classification
Laboratory Confirmation	239	100.0
Clinical form
Acute hepatitis	3	1.3
Chronic asymptomatic hepatitis	236	98.7
Etiological classification
Virus B	217	90.8
Virus B and D	22	9.2

Variable	Exposure n (%)						Total (nºof reports/ nº infected women)
	Yes, less than 6 months ago		Yes, over 6 months ago		No		N	%
	n	%	n	%	n	%
Sexual contact with HBV carriers
No information: 84 (35.1)	16	10.3	14	9.0	125	80.7	30	12.8
Home contact with HBV carriers
No information: 68 (28.5)	15	8.8	20	11.7	136	79.5	35	15.0
Occupational Contact with HBV carriers
No information: 61 (25.5)	0	-	7	3.9	171	96.1	7	3.0
Exposure to injectable drugs
No information: 27 (11.3)	24	11.3	15	7.1	173	81.6	39	16.7
Exposure to tattoos/piercings
No information: 27 (11.3)	9	4.3	21	9.9	181	85.8	30	12.8
Exposure to accident with biological material
No information: 27 (11.3)	1	0.5	0	-	211	99.5	1	0.4
Exposure to inhalable drugs or crack
No information: 27 (11.3)	2	0.9	0	-	210	99.1	2	0.8
Undergoing surgical treatment
No information: 27 (11.3)	3	1.4	20	9.4	189	89.2	23	9.9
Undergoing dental treatment
No information: 27 (11.3)	10	4.7	36	17.0	166	78.3	46	19.6
Exposed to three or more sexual partners
No information: 28 (11.7)	1	0.5	20	9.5	190	90.0	21	9.0
							234	100.0

Instituto de Medicina Integral Prof. Fernando Figueira Rua dos Coelhos, 300. Boa Vista, 50070-550 Recife PE Brasil, Tel./Fax: +55 81 2122-4141 - Recife - PR - Brazil
E-mail: revista@imip.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[TFN1] ^*
no information <5%;

[TFN2] ^**
no information 10-20%; HBV = hepatitis B virus.