Chronic liver disease questionnaire analysis in pregnant women with hepatitis B: a prospective study.

backgroundAlthough domestic and international guidelines increasingly emphasize preventing mother-to-child transmission (MTCT) of hepatitis B virus (HBV), the multidimensional impacts of HBV infection on pregnant women's health-related quality of life (HRQoL) have received insufficient attention. Our previous 1:1 matched cohort study [1] identified HBV infection as an independent risk factor for impaired HRQoL in pregnant women, after adjusting for age, gestational age, and parity. Building upon this foundation, this study is a longitudinal descriptive investigation within the population of HBV-infected pregnant women, aiming to delineate HRQoL trajectories and identify stage-specific factors.

methodsThis study enrolled 126 pregnant women with hepatitis B who attended the Fifth Affiliated Hospital of Guangzhou Medical University between April 2023 and May 2024. The participants were followed up at three time points: 16-24 weeks of gestation, 32 weeks of gestation to delivery, and 5-13 weeks postpartum. The Chronic Liver Disease Questionnaire (CLDQ) was used for longitudinal assessment of changes in their HRQoL. Repeated-measures analysis of variance (RMANOVA) was applied to examine the trends of CLDQ scores, while one-way analysis of variance and multiple linear regression were used to identify influencing factors.

resultsHRQoL in HBV-infected pregnant women showed significant dynamic changes over time (total score time effect: F = 28.363, P < 0.001), with the emotional function and fatigue domains most severely impaired during late pregnancy. In mid-pregnancy, a supportive family environment was positively associated with improved systemic symptoms and emotional function (β = 0.206, P = 0.029; β = 0.366, P = 0.001), whereas out-of-pocket medical expenditures were linked to exacerbated fatigue (β =-0.444, P = 0.044). In late pregnancy, out-of-pocket payments (β =-0.680, P = 0.022) and older age (β =-0.055, P = 0.027) were associated with reduced vitality. During the postpartum period, clinical markers of HBV infection, specifically high viral load (β =-0.403, P = 0.020) and HBeAg positivity (β =-0.336, P = 0.026), correlated with worsened abdominal symptoms and fatigue, respectively. Furthermore, women receiving antiviral therapy for the prevention of mother-to-child transmission demonstrated lower scores in the vitality and emotional function domains (all P < 0.01).

conclusionsHRQoL trajectories in HBV-infected pregnant women exhibit pronounced stage-specific variations, with notable declines in physiological and emotional function during late pregnancy. Different factors influence HRQoL at each stage, suggesting that clinical management should adopt targeted interventions tailored to each phase. Enhanced symptom monitoring and psychological support during late pregnancy and the postpartum period should be prioritized.