Effects of multivitamin supplement, elevit on liver function and maternal-infant outcomes in hepatitis B positive pregnant women
), Tingting Liu(2), Xirui Zhan(3),
(1) Department of gynaecology and obstetrics, The People's Hospital of Yubei District of Chongqing, Chongqing, China
(2) Department of gynaecology and obstetrics, The People's Hospital of Yubei District of Chongqing, Chongqing, China
(3) Department of Clinical Laboratory, Liangjiang Hospital of Chongqing Medical University, China
Corresponding Author
Abstract
This study investigates the effects of elevit supplementation on liver function and maternal-neonatal outcomes in HBsAg-positive pregnant women. A total of 160 participants were divided into a control group (routine care) and an observation group (routine care plus elevit). Liver function markers (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase) were measured in early, mid, and late pregnancy. Maternal complications and neonatal outcomes were recorded, along with adverse reactions. No significant differences in liver enzymes were noted in early pregnancy. However, the observation group showed elevated alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase in mid and late pregnancy, indicating possible liver damage from prolonged elevit use. Despite this, the observation group experienced lower rates of hypertensive disorders, gestational diabetes, intrahepatic cholestasis, postpartum hemorrhage, low birth weight, and preterm birth, as well as higher Apgar scores. Adverse effects were slightly more frequent but not statistically significant. These findings suggest that while elevit may mildly affect liver function, it potentially improves pregnancy outcomes in HBsAg-positive women.
References
Huang Z, Liu T, Qin Y,Chen J,Ou Z. Min, X. A Cross-Sectional Survey on the Rate of Awareness of Hepatitis B Virus (HBV) Infection and the Prevention of Mother-to-Child Transmission among Hepatitis B Surface Antigen (HBsAg)-Positive Pregnant Women. Ann. Transl. Med. 2022,10 (14), 773. https://doi.org/10.21037/atm-22-2748.
Chandran, JR , Raj SV. Efficacy of Antiviral Therapy in HBsAg-Positive Pregnant Women to Reduce Mother-to-Infant Transmission of Hepatitis B Virus. J. Obstet. Gynaecol. India 2018, 68 (5), 355–359. https://doi.org/10.1007/s13224-017-1044-x.
Guo Z, Shi X H, Feng YL, Wan B ,Feng, LP , Wang S P,Zhang YW. Risk Factors of HBV Intrauterine Transmission among HBsAg-Positive Pregnant Women. J. Viral Hepat. 2013, 20 (5), 317–321. https://doi.org/10.1111/jvh.12032.
Guo, Y.; Liu, J.; Meng, L.; Meina, H. and Du, Y. Survey of HBsAg-Positive Pregnant Women and Their Infants Regarding Measures to Prevent Maternal-Infantile Transmission. BMC Infect. Dis. 2010, 10, 26. https://doi.org/10.1186/1471-2334-10-26.
Jiang, R.; Wang, T.; Yao, Y.; Zhou, F. and Huang, X. Hepatitis B Infection and Intrahepatic Cholestasis of Pregnancy: A Systematic Review and Meta-Analysis. Medicine (Baltimore) 2020, 99 (31), e21416. https://doi.org/10.1097/MD.0000000000021416.
Afraie M, Moradi G, Zamani K, Azami M , Moradi, Y. The Effect of Hepatitis B Virus on the Risk of Pregnancy Outcomes: A Systematic Review and Meta-Analysis of Cohort Studies. Virol. J. 2023, 20 (1), 213. https://doi.org/10.1186/s12985-023-02182-0.
Yin W, Chen B, Yang Y, Li X., Li R, Xie J, Chen G, He F,Chen D. Association between Maternal Hepatitis B Virus Carrier and Gestational Diabetes Mellitus: A Retrospective Cohort Analysis. Virol. J. 2021, 18 (1), 226. https://doi.org/10.1186/s12985-021-01691-0.
Xiong Y, Liu C , Huang S, Wang J, Qi Y,Yao G, Sun W, Qian Y, Ye L, Liu H, Xu Q, Zou K, Tan J , Sun, X. Impact of Maternal Infection with Hepatitis B Virus on Pregnancy Complications and Neonatal Outcomes for Women Undergoing Assisted Reproductive Technology Treatment: A Population-Based Study. J. Viral Hepat. 2021, 28 (4), 613–620. https://doi.org/10.1111/jvh.13472.
Wan Z, Zhou A, Zhu H, Lin X, Hu D, Peng S, Zhang B , Du Y. Maternal Hepatitis B Virus Infection and Pregnancy Outcomes: A Hospital-Based Case-Control Study in Wuhan, China. J. Clin. Gastroenterol. 2018, 52 (1), 73–78. https://doi.org/10.1097/MCG.0000000000000842.
Hovdenak N , Haram K. Influence of Mineral and Vitamin Supplements on Pregnancy Outcome. Eur. J. Obstet. Gynecol. Reprod. Biol. 2012, 164 (2), 127–132. https://doi.org/10.1016/j.ejogrb.2012.06.020.
Keats EC, Oh C, Chau T,Khalifa DS, Imdad A, Bhutta ZA. Effects of Vitamin and Mineral Supplementation during Pregnancy on Maternal, Birth, Child Health and Development Outcomes in Low- and Middle-Income Countries: A Systematic Review. Campbell Syst. Rev. 2021, 17 (2), e1127. https://doi.org/10.1002/cl2.1127.
Ning M, Chen Y, Zheng Q, Jia J, Bai B. Insignificant Interference of Elevit in Pregnant Women Serum Samples with HBsAg Immunoassay on Sysmex. J. Clin. Lab. Anal. 2019, 33 (3), e22725. https://doi.org/10.1002/jcla.22725.
González-Fernández D, Muralidharan O, Neves PA, Bhutta ZA. Associations of Maternal Nutritional Status and Supplementation with Fetal, Newborn, and Infant Outcomes in Low-Income and Middle-Income Settings: An Overview of Reviews. Nutrients 2024, 16 (21), 3725. https://doi.org/10.3390/nu16213725.
Haider BA, Bhutta ZA. Multiple-Micronutrient Supplementation for Women during Pregnancy. Cochrane Database Syst. Rev. 2017, 4 (4), CD004905. https://doi.org/10.1002/14651858.CD004905.pub5.
Chen S, Li N, Mei Z, Ye R., Li Z, Liu J , Serdula MK. Micronutrient Supplementation during Pregnancy and the Risk of Pregnancy-Induced Hypertension: A Randomized Clinical Trial. Clin. Nutr. Edinb. Scotl. 2019, 38 (1), 146–151. https://doi.org/10.1016/j.clnu.2018.01.029.
Mu Y, Li M, Zhu J, Wang Y, Xing A, Liu Z, Xie Y, Wang X , Liang J. Apgar Score and Neonatal Mortality in China: An Observational Study from a National Surveillance System. BMC Pregnancy Childbirth 2021, 21 (1), 47. https://doi.org/10.1186/s12884-020-03533-3.
Li F, Wu T, Lei X., Zhang H, Mao M , Zhang JThe Apgar Score and Infant Mortality. PloS One 2013, 8 (7), e69072. https://doi.org/10.1371/journal.pone.0069072.
Tsukuda S, Watashi K. Hepatitis B Virus Biology and Life Cycle. Antiviral Res. 2020, 182, 104925. https://doi.org/10.1016/j.antiviral.2020.104925.
Sausen DG, Shechter O, Bietsch W, Shi Z ,Miller SM.; Gallo ES, Dahari H , Borenstein R. Hepatitis B and Hepatitis D Viruses: A Comprehensive Update with an Immunological Focus. Int. J. Mol. Sci. 2022, 23 (24), 15973. https://doi.org/10.3390/ijms232415973.
Carr AC, Maggini S. Vitamin C and Immune Function. Nutrients 2017, 9 (11), 1211. https://doi.org/10.3390/nu9111211.
Blendis LM. Nutritional Management of Patients with Chronic Liver Disease. Baillieres Clin. Gastroenterol. 1989, 3 (1), 91–108. https://doi.org/10.1016/0950-3528(89)90048-1.
Chalasani N, Younossi Z, Lavine JE, Charlton M.,Cusi K, Rinella M, Harrison SA, Brunt EM , Sanyal AJ. The Diagnosis and Management of Nonalcoholic Fatty Liver Disease: Practice Guidance from the American Association for the Study of Liver Diseases. Hepatol. Baltim. Md 2018, 67 (1), 328–357. https://doi.org/10.1002/hep.29367.
Himoto T , Masaki T. Current Trends of Essential Trace Elements in Patients with Chronic Liver Diseases. Nutrients 2020, 12 (7), 2084. https://doi.org/10.3390/nu12072084.
Himoto T , Masaki T. Associations between Zinc Deficiency and Metabolic Abnormalities in Patients with Chronic Liver Disease. Nutrients 2018, 10 (1), 88. https://doi.org/10.3390/nu10010088.
Tiwari AKM, Mahdi AA , Mishra, S. Assessment of Liver Function in Pregnant Anemic Women upon Oral Iron and Folic Acid Supplementation. J. Gynecol. Obstet. Hum. Reprod. 2018, 47 (2), 45–49. https://doi.org/10.1016/j.jogoh.2017.11.010.
Sairoz null, Prabhu K, Dastidar RG, Aroor AR, Rao M, Shetty S ,Poojari VG, Bs V. Micronutrients in Adverse Pregnancy Outcomes. F1000Research 2022, 11, 1369. https://doi.org/10.12688/f1000research.124960.3.
Fan J , Zhang T, Yu Y, Zhang B. Is Serum Zinc Status Related to Gestational Diabetes Mellitus? A Meta-Analysis. Matern. Child. Nutr. 2021, 17 (4), e13239. https://doi.org/10.1111/mcn.13239.
Mishu FA, Boral N, Ferdous N, Nahar S, Sultana GS, Yesmin MS , Khan NZ. Estimation of Serum Zinc, Copper and Magnesium Levels in Bangladeshi Women with Gestational Diabetes Mellitus Attending in a Tertiary Care Hospital. Mymensingh Med. J. MMJ 2019, 28 (1), 157–162.
Zhou Z, Chen G, Li P, Rao J, Wang L, Yu D, Lin D, Fan D ,Ye S, Wu S, Gou X, Wang H, Guo X, Lin L, Suo D , Liu Z. Prospective Association of Metal Levels with Gestational Diabetes Mellitus and Glucose: A Retrospective Cohort Study from South China. Ecotoxicol. Environ. Saf. 2021, 210, 111854. https://doi.org/10.1016/j.ecoenv.2020.111854.
Celik S, Golbasi H, Gulucu S, Guclu M, Caliskan CS, Celik S,Akpak YK. , Golbasi, C. Role of Vitamin B12 and Vitamin D Levels in Intrahepatic Cholestasis of Pregnancy and Correlation with Total Bile Acid. J. Obstet. Gynaecol. J. Inst. Obstet. Gynaecol. 2022, 42 (6), 1847–1852. https://doi.org/10.1080/01443615.2022.2042797.
Gençosmanoğlu Türkmen G, Vural Yilmaz Z, Dağlar K, Kara Ö, Sanhal CY, Yücel A , Uygur, D. Low Serum Vitamin D Level Is Associated with Intrahepatic
Cholestasis of Pregnancy. J. Obstet. Gynaecol. Res. 2018, 44 (9), 1712–1718. https://doi.org/10.1111/jog.13693.
Geenes, V. and Williamson, C. Intrahepatic Cholestasis of Pregnancy. World J. Gastroenterol. 2009, 15 (17), 2049–2066. https://doi.org/10.3748/wjg.15.2049.
Livera, L. N.; Brookfield, D. S.; Egginton, J. A. and Hawnaur, J. M. Antenatal Ultrasonography to Detect Fetal Renal Abnormalities: A Prospective Screening Programme. BMJ 1989, 298 (6685), 1421–1423. https://doi.org/10.1136/bmj.298.6685.1421.
Cooper, C.; Harvey, N. C.; Bishop, N. J.; Kennedy, S.; Papageorghiou, A. T.; Schoenmakers, I.; Fraser, R.; Gandhi, S. V.; Carr, A.; D’Angelo, S.; Crozier, S. R.; Moon, R. J.; Arden, N. K.; Dennison, E. M.; Godfrey, K. M.; Inskip, H. M.; Prentice, A.; Mughal, M. Z.; Eastell, R.; Reid, D. M.; Javaid, M. K. anMAVIDOS Study Group. Maternal Gestational Vitamin D Supplementation and Offspring Bone Health (MAVIDOS): A Multicentre, Double-Blind, Randomised Placebo-Controlled Trial. Lancet Diabetes Endocrinol. 2016, 4 (5), 393–402. https://doi.org/10.1016/S2213-8587(16)00044-9.
Keats, E. C.; Haider, B. A.; Tam, E. and Bhutta, Z. A. Multiple-Micronutrient Supplementation for Women during Pregnancy. Cochrane Database Syst. Rev. 2019, 3 (3), CD004905. https://doi.org/10.1002/14651858.CD004905.pub6.
Zhou, Z.; Yu, D.; Chen, G.; Li, P.; Wang, L.; Yang, J.; Rao, J.; Lin, D.; Fan, D.; Wang, H.; Gou, X.; Guo, X.; Suo, D.; Huang, F. and Liu, Z. Fasting Plasma Glucose Mediates the Prospective Effect of Maternal Metal Level on Birth Outcomes: A Retrospective and Longitudinal Population-Based Cohort Study. Front. Endocrinol. 2021, 12, 763693. https://doi.org/10.3389/fendo.2021.763693.
Asemi, Z.; Samimi, M.; Tabassi, Z. and Ahmad, E. Multivitamin Versus Multivitamin-Mineral Supplementation and Pregnancy Outcomes: A Single-Blind Randomized Clinical Trial. Int. J. Prev. Med. 2014, 5 (4), 439–446.
Santander Ballestín, S.; Giménez Campos, M. I.; Ballestín Ballestín, J. and Luesma Bartolomé, M. J. Is Supplementation with Micronutrients Still Necessary during Pregnancy? A Review. Nutrients 2021, 13 (9), 3134. https://doi.org/10.3390/nu1309313.
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