Fan Zhang1, Jiefei Wang2, Jilin Cheng3, Xiaohong Zhang4, Qiyu He1, Liang Zhaochao1, Jingyi Shu1, Li Yan5, Ling Wang6, Lin Wang7, Jianliang Zhang8. 1. Department of Microbiology and Infectious Disease Centre, School of Basic Medical Sciences, Peking University Health Science Centre, No. 38 Xueyuan Road, Beijing 100191, China. 2. Department of Severe Hepatology, Shanghai Public Health Clinical Centre, Fudan University, 2901 Caolang Road, Jin-Shan, Shanghai 201508, China. 3. Department of Gastroenterology and Hepatology, Shanghai Public Health Clinical Centre, Fudan University, 2901 Caolang Road, Jin-Shan, Shanghai 201508, China. 4. Department of Obstetrics and Gynecology, Shanghai Public Health Clinical Centre, Fudan University, Shanghai, China. 5. Department of Severe Hepatology, Shanghai Public Health Clinical Centre, Fudan University, 2901 Caolang Road, Jin-Shan, Shanghai 201508, China. Electronic address: yl1109@163.com. 6. Department of Microbiology and Infectious Disease Centre, School of Basic Medical Sciences, Peking University Health Science Centre, No. 38 Xueyuan Road, Beijing 100191, China. Electronic address: lingwang@bjmu.edu.cn. 7. Department of Microbiology and Infectious Disease Centre, School of Basic Medical Sciences, Peking University Health Science Centre, No. 38 Xueyuan Road, Beijing 100191, China. Electronic address: lin_wang@pku.edu.cn. 8. Department of Gastroenterology and Hepatology, Shanghai Public Health Clinical Centre, Fudan University, 2901 Caolang Road, Jin-Shan, Shanghai 201508, China. Electronic address: zhangjianliang@shaphc.org.
Abstract
OBJECTIVES: Hepatitis E virus (HEV) infection causes high mortality in pregnant women of developing regions during large outbreaks. The aim of this study was to investigate the clinical features of HEV-infected pregnant women in Shanghai, China where the epidemiology of HEV has shifted from large outbreaks to the sporadic form. METHODS: Clinical data of 516 pregnant and nonpregnant child-bearing age women diagnosed with HEV infection during 2009-2020 was collected at the Shanghai Public Health Clinical center. Patients' data were analysed for clinical features and laboratory parameters accordingly. RESULTS: Most of the hospitalized HEV-infected pregnant women (85.23%, 127/149) showed no obvious clinical symptoms and the disease outcome was generally benign with no liver failure or maternal mortality observed in the patients. By comparison, fewer (37.21%, 32/86) of the HEV-infected nonpregnant women were asymptomatic, and five cases (5.81%, 5/86) of liver failure were observed among them. The levels of serum alanine aminotransferase, aspartate aminotransferase, total bilirubin (TBiL), direct bilirubin (DBiL) and total bile acids (TBA) were significantly higher (P < 0.05) in nonpregnant women than those of the pregnant women. We found 42.99% (46/107) births had adverse foetal/neonatal outcome. Mothers who presented with adverse foetal/neonatal outcome showed higher (P < 0.05) serum TBiL, DBiL and TBA levels than those without. CONCLUSION: We found that the clinical features of sporadic HEV infection in pregnant women in Shanghai, China are generally mild and no maternal mortality occurred. However foetal/neonatal adverse outcomes including preterm births and stillbirths were observed in HEV-infected pregnant women.
OBJECTIVES: Hepatitis E virus (HEV) infection causes high mortality in pregnant women of developing regions during large outbreaks. The aim of this study was to investigate the clinical features of HEV-infected pregnant women in Shanghai, China where the epidemiology of HEV has shifted from large outbreaks to the sporadic form. METHODS: Clinical data of 516 pregnant and nonpregnant child-bearing age women diagnosed with HEV infection during 2009-2020 was collected at the Shanghai Public Health Clinical center. Patients' data were analysed for clinical features and laboratory parameters accordingly. RESULTS: Most of the hospitalized HEV-infected pregnant women (85.23%, 127/149) showed no obvious clinical symptoms and the disease outcome was generally benign with no liver failure or maternal mortality observed in the patients. By comparison, fewer (37.21%, 32/86) of the HEV-infected nonpregnant women were asymptomatic, and five cases (5.81%, 5/86) of liver failure were observed among them. The levels of serum alanine aminotransferase, aspartate aminotransferase, total bilirubin (TBiL), direct bilirubin (DBiL) and total bile acids (TBA) were significantly higher (P < 0.05) in nonpregnant women than those of the pregnant women. We found 42.99% (46/107) births had adverse foetal/neonatal outcome. Mothers who presented with adverse foetal/neonatal outcome showed higher (P < 0.05) serum TBiL, DBiL and TBA levels than those without. CONCLUSION: We found that the clinical features of sporadic HEV infection in pregnant women in Shanghai, China are generally mild and no maternal mortality occurred. However foetal/neonatal adverse outcomes including preterm births and stillbirths were observed in HEV-infected pregnant women.