Paternal HBV Infection Prior to Pregnancy May Increase CHD Risk in Offspring

Paternal hepatitis B virus (HBV) infection prior to pregnancy is associated with increased risk for congenital heart disease (CHD) in offspring, according to study results published in JAMA Pediatrics.

Researchers in China conducted a matched retrospective cohort study from January 2010 to December 2018 to evaluate the association between paternal preconception HBV infection status and CHD risk in offspring. Study patients included married men with and without preconception HBV infection whose wives were aged between 20 and 49 years, uninfected with HBV, and had conceived within 1 year after prepregnancy examination. Data were collected on maternal HBV status, which was categorized as immune or susceptible. Logistic regression with robust error variances was employed to examine the relationship between paternal preconception HBV infection and CHD occurrence in offspring.

The final analysis included 3,047,924 couples who were matched 1:4 on the basis of the husbands’ (median age, 27 [IQR, 25-30] years) preconception HBV status (positive vs negative). Among the 610,978 matched husbands, 376,221 (61.6%) were newly infected with HBV and 234,757 (38.4%) were previously infected. Overall, 0.025% of these couples had offspring with CHD.

The researchers found that previous paternal HBV infection was associated with increased risk for CHD in offspring (adjusted relative risk [aRR], 1.40; 95% CI, 1.11-1.76). A subgroup analysis of wives with HBV susceptibility indicated similar findings, with previous paternal infection before the wife’s pregnancy linked higher CHD risk in offspring (aRR, 1.46; 95% CI, 1.08-1.98).

Of couples within whom the husband had previously been infected with HBV, the risk for CHD occurrence in offspring was similar regardless of susceptible (aRR, 1.49; 95% CI, 1.10-2.03) vs immune (aRR, 1.49; 95% CI, 1.07-2.09) maternal HBV status.

The researchers observed significantly higher CHD risk in the offspring of couples within whom the husband was newly infected with HBV and the wife was immune (aRR, 1.38; 95% CI, 1.05-1.82). However, no increased CHD risk was identified in the offspring of couples within whom the husband was newly infected with HBV and the wife was susceptible (aRR, 0.99; 95% CI, 0.72-1.36).

No associations were discovered between maternal immune status and paternal HBV infection prior to pregnancy.

Limitations of this study include the lack of data on HBV viral loads, the absence HBV treatment records, and incomplete information on other potential confounding factors.

According to the researchers, “[P]ersonalized reproductive guidance regarding undergoing HBV screening and staying free of HBV infection should be provided for both wives and husbands, which might be helpful for the reduction of congenital malformation risk and improvement of neonatal outcomes.”

This article originally appeared on Infectious Disease Advisor