Maternal Hepatitis B Associated With Higher Preterm Birth Risk in IVF Pregnancies: Study

Maternal hepatitis B infection did not appear to reduce pregnancy or live-birth rates after IVF or ICSI, but women with hepatitis B had a higher rate of preterm birth, according to a new study.

Researchers retrospectively analysed 3,455 first-time fresh IVF or ICSI embryo-transfer cycles at a reproductive medicine centre in China between 2018 and 2020. The study included 811 cycles involving women with hepatitis B and 2,644 cycles in which neither partner had hepatitis B surface antigen.

After matching the groups to account for differences in their baseline characteristics, researchers compared 810 closely matched pairs. They assessed outcomes at different stages, including egg maturation, fertilisation, embryo development, implantation, pregnancy, delivery and newborn health.

The analysis found no significant differences in egg maturation, normal fertilisation, development of high-quality embryos or formation of blastocysts between the two groups.

Pregnancy rates were also similar. Clinical pregnancy occurred in 44.44% of women with hepatitis B compared with 45.43% of women without the infection. Live-birth rates were 32.59% and 32.96%, respectively.

There were also no significant differences in implantation, miscarriage, stillbirth or ectopic pregnancy. Pregnancy-related complications, including gestational hypertension, gestational diabetes and premature rupture of membranes, were also similar between groups.

However, preterm birth was more common among women with hepatitis B. After matching, 15.73% of births in the hepatitis B group were preterm, compared with 7.78% in the control group.

Researchers said the reason for this association is unclear. Chronic inflammation, changes in the immune system and effects on the placenta may play a role. However, the study did not have detailed information about viral load, antiviral treatment or liver function.

The study was retrospective and conducted at a single centre, so it cannot prove that hepatitis B causes preterm birth.

The findings suggest that maternal hepatitis B may not substantially affect IVF or ICSI success, but the higher preterm-birth rate may warrant closer monitoring during pregnancy.

REFERENCE: Jiang W et al. The impact of maternal hepatitis B virus infection on IVF/ICSI-assisted pregnancy outcomes: a propensity score-matched cohort study. Front Med. 2026;13:1925066.