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Table 1 General characteristics and quality scores of the 14 studies included in this meta-analysis

From: A meta-analysis of the association between gestational diabetes mellitus and chronic hepatitis B infection during pregnancy

No Author, publication year, design (matched variables), study site, country, PW (no, HBsAg +%) , enrolled period (and NOS) Inclusion/exclusion Identification of HBsAg/GDM (data retrieval) Baseline comparison between HBsAg + and HBsAg- PW Effect estimation (95% CI)/adjustment variables
Similarity Dissimilarity
1. Wong SF, 1999 PW delivered after 24 GW or babies with BW ≥ 500 g/AHP, non-SP, acute pelvic inflammatory disease, STI, smoker or illicit drug users, and DM ELISA/Australian criteria (computer database) Mean age, parity, history of abortion NA ORc = 1.05 (0.69, 1.61)
RCS, with all HBsAg- as controls
ORa = 1.00 (0.56,1.76)*1/NA
Princess Margaret Hospital
Hongkong, China
SP (7105, 11.6%)
Jul.1,1996-Aug.31,1998 (6)
2. Lao TT, 2003 Chinese PW, recruited at 28-30 GW, haemoglobin concentration ≥10 g/dl and mean cell volume ≥ 80 fL at the initial visit at or before 14 GW/antenatal visit after 14 GW, anemia or hemoglobinopathy, GDM diagnosed before 28 GW, non-SP ELISA/WHO criteria (medical record) Weight, height, BMI, parity, socioeconomic status The HBsAg + PW were significantly older, with more OGTTs performed, with higher iron status, with higher prevalence of past obstetric history, family or medical history and had an advanced age (≥35 years) RRc = 2.97 (2.00, 4.42)
RCS, with a sample as controls ORc = 3.94 (2.27, 6.84)
Queen Mary Hospital or others RRa = 3.51 (1.83, 6.73)/Age, BMI, socioeconomic status, parity and presence of significant obstetrics, family and past history.
Hongkong, China
SP (767, NA)
Over four months (5)
3. To WWK, 2003 PW delivered after 24 GW/AHP(2); incomplete or contradicting data(152) ELISA/Australian criteria (computer database) Age, GW at delivery, BMI, parity, incidence of non-SP or STIs; no clinical manifestations of liver disorders or hepatitis. A higher prop. of HBsAg + PW from mainland China ORc = 0.81 (0.59, 1.12 )
RCS, with all HBsAg- as controls
ORa = 0.77 (0.47, 1.26)*1/NA
United Christian Hospital
Hongkong, China
AP (13946, 9.72%)
Jan. 1997-Dec. 2000 (6)
4. Tse KY, 2005 NA/incomplete data ELISA/WHO criteria (medical record) BMI, height, weight and Hb level at booking, ethnic, history of stillbirth, IVF pregnancy, haemoglobin level at booking, past medical history Among the HBsAg + PW, the weight gain in those with GDM was significant less than those without GDM. ORc = 1.89 (1.14, 3.13)
RCS, matched for age and parity
ORa = 2.04 (1.21, 3.44)/Age, weight and parity
Queen Mary Hospital (section mainly for high-risk paturients)
Hongkong, China
SP (3348, 7.56%) Among the HBsAg- PW, the weight gain in those with GDM was non-significant less than those without GDM.
Jan. 2000-2002 (7)
5. Lao TT, 2007 SP, 99% of those PW delivered at or after 24 GW/incomplete data (147) ELISA/ WHO criteria*4 (computer database, ICD coding) Age, height, parity and history of DM The HBsAg + PW had lower weight and BMI, with lower prop. of overweight and smokers, and with higher prop. of Asian origin, married, unemployed and history of induced abortion. ORc = 1.31(1.08, 1.57)
RCS, with all HBsAg- as controls
ORa = 1.24 (1.01, 1.51)/parity, age, BMI, presence of iron deficiency anaemia, and smoking.
Queen Mary Hospital
Hongkong, China
SP (14464, 8.3%)
1998-2001 (8)
6. Lert-amornpong S,2007 Healthy PW Age 20-39 years old/chronic illness, non-SP, HIV+, smoker, alcohol drinker ELISA/NDDG (medical record) Age, weight at booking, weight gain, hematocrit at booking, history of contraception, parity and past health. NA ORc = 3.04 (0.60, 15.28)
RCS, matched for age and date of delivery
ORa = 2.89 (0.55, 15.17)*1/NA
Phramongkutklao College of Medicine
SP (8515, 1.93%)
Jan.1, 2003-Dec.31,2005 (5)
7. Thungsuk R, 2008 Healthy PW ELISA/ADA (medical record) Age, hematocrit at booking, parity and past health NA ORc = 1.39 (0.37, 5.28)
RCS, matched for age, parity and year of delivery Age 20-39 years old/chronic illness, non-SP, HIV+, smoker, alcohol drinker
ORa = 1.32 (0.33, 5.29)*1/NA
Sawanpracharak Hospital
Nakhonsawan, Thailand
AP (2548, 1.3%)
Jan. 2005-Dec, 2007 (5)
8. Saleh-Gargari S, 2009 SP/AHP ELISA/ADA (medical record) Age, parity, BMI, hemoglobin level at admission, past health history NA ORc = 4.13 (1.96, 8.70)
RCS, matched for age, parity, and BMI
ORa = 3.62 (1.60, 7.90)/NA
the labor ward in Mahdieh and Vali Asr Tertiary Care Hospital
Tehran, Iran
Mar. 2001-Dec. 2008 (6)
9. Aghamohammadi A, 2011 SP/ ELISA/ADA (medical record) Age, parity, haemoglobin level at booking, past medical history NA ORc = 2.34 (1.32, 4.17)
RCS, matched for age and parity, selected at random AHP ORa = 1.53 (1.19, 1.97)/NA
the labor ward in Imam Khomeyni
Sari, Iran
SP (2953, 5.07%)
Jan.,2005-Dec.,2008 (6)
10. Lobstein S, 2011 SP (8193)/non-SP (427); HBsAg not available (887) ELISA/IADPSG (computer database) BMI, age, history of stillbirths, ectopic pregnancies, IVF pregnancies The HBsAg + PW had lower weight and height, higher prop. of Asian origin, married, unemployed, history of induced abortion, and lower prop. of primipara ORc = 2.82 (0.17, 46.68)
RCS, with all HBsAg- as controls
ORa = 2.20 (0.13, 37.03)*1/NA
Gynecological University Hospital
Leipizig, Germany
AP (9507, 0.48%)
Jan 1, 2001-Dec. 31,2006 (6)
11. Reddick KL, 2011 NA/DM, HCV ELISA/ADA NA The HBsAg + PW were younger, with more black and Asian, and higher prop. of public-assisted insurance, any substance use, any STI and medical complications ORc = 1.78 (1.27, 2.50)
RCS, with all HBsAg- as controls
ORa = 1.39 (0.88, 2.12)/age, race, insurance status, substance use, STI and medical complications
1054 hospitals
37 states, USA
AP (297664, 0.27%)
1995–2005 (8)
12. Lu YP, 2012 SP/pre-existing diabetes, impaired glucose tolerance, hypertension, etc; syphilis, HIV; co-infected or super-infected with HCV, HDV, HAV, HEV and other infections, smokers drug users, alcohol drinkers and prescription users. ELISA/ADA (medical record) Age, height, BMI before pregnancy, parity, times of pregnancy, GW NA ORc = 0.90 (0.48, 1.67)
RCS, with a random sample of all HBsAg- as controls
ORa = 0.85 (0.41, 1.77)*1/NA
First Affiliated Hospital of Jinan University
May 2009-Jul. 2011 (6)
13. Lao TT, 2013 PW delivered at or after 24 GW/NA ELISA/Australian criterion (computer database, ICD coding) Height and medical history The HBsAg + PM were insignificantly younger, and with higher prop. of overweight, BMI and multiple parity ORc = 0.96 (0.88, 1.04)
RCS, with all HBsAg- as controls ORa = 0.91 (0.62, 1.34)*1/NA
Princess of Wales Hospital
Hongkong, China
SP (86537, 10.0%)
Jan. 1995-Dec. 2009 (5)
14. Mak SL, 2013 PW delivered after 24 GW ELISA/Australian criterion (computer database) Maternal condition and past medical health Parity was higher in HBsAg + PW ORc = 0.97 (0.74, 1.28)
RCS, with all HBsAg- as controls
ORa = 0.92 (0.58, 1.48)*1/NA
Queen Elizabeth Hospital
Hongkong, China
AP (9526, 7.85%)
Oct. 1st, 2010- Dec. 31st, 2011 (6)
  1. Notes.
  2. PW: pregnant women; NOS: Newcastle-Ottawa Quality Assessment Scale; no: number; HBsAg: hepatitis B virus surface antigen; GDM: gestational diabetes mellitus; CI: confidence interval; RCS: retrospective cohort study; SP: single pregnancy; GW: gestational weeks; BW: birth weight; AHP: acute hepatitis during pregnancy; STI: sexually transmitted infection; DM: diabetes mellitus; ELISA: Enzyme-linked immunosorbent assay; NA: not available; ORc: crude odds ratio; ORa: adjusted odds ratio; WHO: World Health Organization; BMI: body mass index; OGTT: oral glucose tolerance test; RRc: crude risk ratio; RRa: adjusted risk ratio; Hb: haemoglobin; IVF: In vitro fertilization; prop: proportion; HIV: human immunodeficiency virus; NDDG: National Diabetes Data Group; ADA: American Diabetes Association; IADPSG: International Association of Diabetes in Pregnancy Study Group; HCV: hepatitis C virus; HDV: hepatitis D virus; HAV: hepatitis A virus; HEV: hepatitis E virus; ICD: International Classification of Diseases.
  3. *1ORa was calculated using external estimates of confounding by the method of coefficient adjustment.