OBJECTIVES: To evaluate the impact of HBV infection on pre- and postpartum health-related quality of life (HRQoL) in pregnant women. METHODS: A prospective matched cohort consisting of 70 HBV-infected and 70 healthy pregnant women was recruited from the Fifth Affiliated Hospital of Guangzhou Medical University between April 17 and September 25, 2023. HRQoL of the participants was assessed at 16-24 weeks of gestation, between 32 weeks and delivery, and 5-13 weeks postpartum. Mixed linear models were used for evaluating temporal trends of HRQoL changes, and univariate ANOVA with multiple linear regression was used to identify the predictors of HRQoL. RESULTS: Compared with healthy pregnant women, HBV-infected pregnant women had consistently lower total HRQoL scores across all the 3 intervals, with the lowest scores observed between 32 weeks of gestation and delivery, during which these women had significantly reduced mental component scores (74.27±13.43 vs 80.21±12.9, P=0.009) and postpartum mental (76.52±16.19 vs 85.02±6.51, P<0.001) and physical component scale scores (77.17±14.71 vs 83.09±10.1, P=0.009). HBV infection was identified as an independent risk factor affecting HRQoL during late pregnancy and postpartum periods. Additional independent risk factors for postpartum HRQoL reduction included self-pay medical expenses, spouse's neutral attitude toward the current pregnancy, and preexisting comorbidities (all P<0.05). CONCLUSIONS HRQoL of pregnant women deteriorates progressively in late pregnancy, and HBV infection exacerbates reductions of physical function and role emotion in late pregnancy and after delivery, suggesting the importance of targeted interventions for financial burdens, partner support and comorbid conditions to improve HRQoL of pregnant women with HBV infection.
Humans ; Female ; Pregnancy ; Quality of Life ; Prospective Studies ; Postpartum Period ; Hepatitis B, Chronic/psychology* ; Adult ; Pregnancy Trimester, Third ; Pregnancy Trimester, Second ; Pregnancy Complications, Infectious

Objective To explore the factors influencing the efficacy of postoperative first 131Ⅰ therapy in patients with papillary thy-roid carcinoma(PTC)with cervical lymph node metastases detected by iodine and low stimulated thyroglobulin(sTg)level(sTg<10 μg/L).Methods Retrospective analysis of 98 postoperative PTC patients with low sTg level and no distant metastases at the time of their first 131Ⅰ treatment at Hangzhou Cancer Hospital between July 2014 and April 2021 was conducted.According to the post-treatment whole body scan(Rx-WBS)results,the patients were divided into two groups:a group with cervical lymph node metastasis detected by iodine(LN+,n=53)and a group without cervical lymph node metastasis detected by iodine(LN-,n=45).Efficacy evaluation was performed 6 months after 131Ⅰ treatment by determining whether excellent response(ER)was achieved based on sTg levels and the results of diagnostic whole body scan(Dx-WBS)and other imaging tests.The LN+and LN-groups were compared in terms of age,sex,sTg level,anti-thyroglobulin antibody(TgAb)level,ER rate,T stage,N stage,the number of lymph node metastases in pathology,and the dose of 131Ⅰ treatment.Uni-variate and multivariate logistic analyses were performed to find the factors affecting the efficacy of the treatment.The predictive value and optimal diagnostic thresholds of these factors were assessed by receiver operating characteristic(ROC)curves.Results Between the LN+and LN-groups,there were significant differences in ER rate 6 months after the first 131Ⅰ treatment,sTg level,and the number of lymph node metastases in pathology(all P<0.05),and no significant differences in age,sex,T stage,N stage,TgAb level,and 131Ⅰ treatment dose(all P>0.05).Univariate logistic regression analysis showed that patients'sTg level and the number of lymph node metastases in pathology were associated with the efficacy of 131Ⅰ treatment(both P<0.05).Multivariate analysis showed that sTg level was a determinant factor influencing the efficacy of 131Ⅰ treatment(P<0.05).The area under the ROC curve for pretreatment sTg level predicting ER was 0.799(95%CI:0.708-0.889).The sensitivity and specificity of predicting ER at the cutoff value of sTg level which was 2.655 μg/L were 69.2%and 77.8%,re-spectively.Conclusions In postoperative PTC patients with low sTg level accompanied by cervical lymph node metastases detected by iodine,the short-term efficacy of 131Ⅰ therapy is overall inferior to that in those without cervical lymph node metastases detected by iodine.sTg level is an independent risk factor affecting the prognosis of 131Ⅰ therapy in this group of patients,and those with low sTg level have a higher likelihood of achieving a satisfactory outcome after 131Ⅰ therapy.

Objective To explore the factors influencing the efficacy of postoperative first 131Ⅰ therapy in patients with papillary thy-roid carcinoma(PTC)with cervical lymph node metastases detected by iodine and low stimulated thyroglobulin(sTg)level(sTg<10 μg/L).Methods Retrospective analysis of 98 postoperative PTC patients with low sTg level and no distant metastases at the time of their first 131Ⅰ treatment at Hangzhou Cancer Hospital between July 2014 and April 2021 was conducted.According to the post-treatment whole body scan(Rx-WBS)results,the patients were divided into two groups:a group with cervical lymph node metastasis detected by iodine(LN+,n=53)and a group without cervical lymph node metastasis detected by iodine(LN-,n=45).Efficacy evaluation was performed 6 months after 131Ⅰ treatment by determining whether excellent response(ER)was achieved based on sTg levels and the results of diagnostic whole body scan(Dx-WBS)and other imaging tests.The LN+and LN-groups were compared in terms of age,sex,sTg level,anti-thyroglobulin antibody(TgAb)level,ER rate,T stage,N stage,the number of lymph node metastases in pathology,and the dose of 131Ⅰ treatment.Uni-variate and multivariate logistic analyses were performed to find the factors affecting the efficacy of the treatment.The predictive value and optimal diagnostic thresholds of these factors were assessed by receiver operating characteristic(ROC)curves.Results Between the LN+and LN-groups,there were significant differences in ER rate 6 months after the first 131Ⅰ treatment,sTg level,and the number of lymph node metastases in pathology(all P<0.05),and no significant differences in age,sex,T stage,N stage,TgAb level,and 131Ⅰ treatment dose(all P>0.05).Univariate logistic regression analysis showed that patients'sTg level and the number of lymph node metastases in pathology were associated with the efficacy of 131Ⅰ treatment(both P<0.05).Multivariate analysis showed that sTg level was a determinant factor influencing the efficacy of 131Ⅰ treatment(P<0.05).The area under the ROC curve for pretreatment sTg level predicting ER was 0.799(95%CI:0.708-0.889).The sensitivity and specificity of predicting ER at the cutoff value of sTg level which was 2.655 μg/L were 69.2%and 77.8%,re-spectively.Conclusions In postoperative PTC patients with low sTg level accompanied by cervical lymph node metastases detected by iodine,the short-term efficacy of 131Ⅰ therapy is overall inferior to that in those without cervical lymph node metastases detected by iodine.sTg level is an independent risk factor affecting the prognosis of 131Ⅰ therapy in this group of patients,and those with low sTg level have a higher likelihood of achieving a satisfactory outcome after 131Ⅰ therapy.