Correlation between maternal serum pgRNA levels during pregnancy and neonatal virological characteristics at birth in HBV-infected pregnant women

Abstract

To investigate the relationship between serum pregenomic RNA (pgRNA) in pregnant women with chronic HBV (CHB) infection during pregnancy and maternal clinical characteristics, virological characteristics of newborns at birth, and mother-to-child transmission (MTCT) outcomes. 312 pregnant women with CHB and their newborns were followed up for 12 months, and their clinical data were collected. Spearman correlation analysis was used to evaluate associations between maternal indicators and neonatal outcomes, and logistic regression analysis was performed to identify factors associated with neonatal HBeAg positivity. Maternal HBV DNA, HBsAg, and HBeAg levels were significantly higher in the pgRNA-positive group. All infants followed up to 12 months were negative for both HBsAg and HBV DNA, yielding a 100% success rate of MTCT prevention. Neonatal HBeAg levels at birth were associated with maternal pgRNA levels. Maternal pgRNA levels were significantly higher in mothers of HBeAg-positive newborns than in those of HBeAg-negative newborns, whereas no significant association was found between maternal pgRNA levels and neonatal HBsAg or HBV DNA status. Neonatal HBeAg level was weakly positively correlated with maternal pgRNA levels ( r = 0.17, P < 0.01) and maternal HBeAg levels ( r = 0.12, P < 0.05). Maternal pgRNA, HBeAg, HBsAg, HBV DNA, age, and treatment were identified as factors associated with neonatal HBeAg status, whereas multivariate analysis showed that only maternal HBeAg remained an independent associated factor. Maternal serum pgRNA is associated with neonatal HBeAg status at birth. However, under standardized combined immunoprophylaxis, maternal pgRNA was not associated with MTCT failure.