Hepatitis B surface antigen positive on pregnancy outcomes and BMI z-score in offspring: a population-based study, China, 2011-2018

Background: Hepatitis B surface antigen (HBsAg) positive leads to pregnancy outcomes and effects on offspring BMI z-score remains unclear in China. We are aim to explore if there is an association among HBsAg positive, BMI z-score, and pregnancy outcomes. Methods: We extracted the characteristic information and pregnancy outcomes of pregnant women, and BMI z-score from 1 to 3 years in offspring from the Medical Birth Registry of Xiamen that registered between 1 March 2011 and 30 March 2018. Results: Pregnant women with HBsAg positive had a higher risk of gestational diabetes mellitus (GDM) (1.128, 1.032-1.232), and cesarean delivery (1.116, 1.026-1.213). Interestingly, there is no difference between HBsAg positive and offspring BMI z-score (all P > 0.05). Additionally, the GDM women with HBsAg positive had higher incidence of low-for-gestation age (LGA), preterm birth, and cesarean delivery (22.95%, 9.48%, and 47.88%, respectively) (all P < 0.001). Conclusions: HBsAg positive may be a risk factor of GDM and cesarean delivery. However, HBsAg positive has no effects on offspring BMI z-score. Therefore, women should perform GDM and HBsAg screening before or during pregnancy. As well, a larger follow-up population study should be performed to confirm the association between HBsAg positive and offspring BMI z-score.