Patient-reported outcomes in mothers with chronic hepatitis B infection: A cross-sectional analysis

The health-related quality of life (HRQoL) during pregnancy has not been well-lidated in mothers with chronic hepatitis B (CHB). We aim to compare patient-reported outcomes (PROs) in CHB mothers with those of healthy mothers during pregnancy.

Between 4/16/2023 and 7/31/2023, we invited consecutive CHB and healthy mothers to complete the self-administered 36-item Short Form Survey (SF-36) and the Chronic Liver Disease Questionnaire (CLDQ) for PRO assessment. Pairwise comparisons of PRO scores between groups were performed using chi-square tests. Covariates for worse PROs were further analyzed by the multiple linear regression model to identify the independent predictors RESULTS: Among 257 participants (CHB: healthy control was 100:157), the mean (SD) age was 29.6 (3.4), and the majority completed the PRO assessment at the gestational weeks of 16-24. When compared to healthy mothers, CHB mothers had a significant impairment of PROs in the CLDQ domain of worry (6.97±0.16 vs 5.83±0.99, p<0.05) and the SF-36 domain of social functioning (95.33±10.00 vs 91.67±16.37, p<0.05). The subgroup analyses in CHB mothers showed HBV DNA >200,000 IU/mL associated with significantly worse PROs. The multivariate analyses identified CHB infection, severe nausea or vomiting, poor living conditions, and spousal negative attitude as independent predictors of HRQoL impairment.

This study suggests that CHB infection during pregnancy negatively impacted HRQoL, particularly in worry and social functioning domains. CHB infection was an independent predictor for PRO impairments. Further integration of monitoring and intervention on HRQoL impairment should be considered when managing CHB mothers during pregnancy.