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Effect of Hepatitis B virus infection during pregnancy on the risk of postpartum hemorrhage: a systematic review and meta-analysis.

Frontiers in global women's health·January 2025·Jingwen Chen, Ke Deng, Peng Zhao et al.
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Key Finding

Maternal Hepatitis B virus infection during pregnancy is associated with a 50% increased risk of postpartum hemorrhage compared to uninfected mothers.

What This Means For You

This study examined whether pregnant women infected with Hepatitis B virus (HBV) face a higher risk of postpartum hemorrhage—excessive bleeding after childbirth. Researchers reviewed 21 studies involving nearly 380,000 participants from multiple countries. They found that women with HBV infection during pregnancy had an 18-50% increased risk of experiencing postpartum hemorrhage compared to women without HBV infection. This association remained consistent across different population sizes, geographic regions, and areas with varying rates of HBV infection.

Postpartum hemorrhage is a serious complication that can occur after delivery, and understanding risk factors helps healthcare providers prepare appropriate interventions. The study suggests that HBV infection affects blood clotting mechanisms or liver function in ways that may contribute to increased bleeding risk after childbirth. While this research doesn't directly involve acupuncture, it identifies a specific population that may benefit from supportive care during pregnancy and delivery.

For pregnant women with HBV infection, this information highlights the importance of comprehensive prenatal care and close monitoring during delivery. Acupuncture has been studied for various pregnancy-related conditions and postpartum recovery support, though this particular study did not evaluate acupuncture interventions. Women interested in complementary approaches during pregnancy should discuss all options with their obstetric care team to ensure coordinated, safe care. If considering acupuncture during pregnancy or postpartum, always work with a licensed acupuncturist experienced in treating pregnant and postpartum women.

Clinical Notes for Practitioners

This systematic review and meta-analysis examined the association between maternal HBV infection and postpartum hemorrhage risk. Researchers analyzed 21 cohort studies encompassing 379,782 participants across multiple databases through June 2024. The pooled unadjusted analysis demonstrated a statistically significant increased risk of PPH in HBV-infected mothers (crude RR = 1.18, 95% CI: 1.06-1.31). Adjusted data revealed a stronger association (aOR = 1.50, 95% CI: 1.29-1.73). Results remained consistent across subgroup analyses stratified by sample size, geographic region, and HBV prevalence. Sensitivity analyses confirmed robustness of findings. The Newcastle-Ottawa scale assessed study quality. The mechanism may involve HBV-related coagulopathy or hepatic dysfunction affecting hemostasis. Clinical takeaway: Practitioners should maintain heightened awareness of PPH risk in HBV-positive patients, ensuring appropriate monitoring and preparedness for hemorrhage management during delivery. Future research should investigate the impact of HBeAg status and viral load on PPH risk.

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