Psychological stress; knowledge, attitude and practice and acceptance of antiviral therapy in pregnant women with hepatitis B in Zhejiang, China: a case comparison study

Objectives To determine knowledge, attitude and practice (KAP) and antiviral therapy's acceptance during pregnancy of pregnant women with hepatitis B and influencing factors. Design Case-comparison study. Setting The study was conducted in Zhejiang province, China, from September 2019 to December 2020. Participants Pregnant and postpartum women with chronic hepatitis B. Primary and secondary outcome measures The stress scores, self-assessed health score, KAP, antiviral therapy's acceptance rate during pregnancy and influencing factors were analysed. The Perceived Stress Scale-10 was used to assess stress. Logistic regression was used to analyse influencing factors on antiviral therapy. Results The self-assessed health score of pregnant women without liver diseases (82.4 +/- 9.3) was significantly higher than that of pregnant women with chronic hepatitis B (75.5 +/- 9.5) and postpartum (75.1 +/- 14.1). Psychological stress of pregnant women with chronic hepatitis B was significantly high with a 14.9 +/- 3.6 score, but there was no significant difference between hepatitis B postpartum and non-liver disease women (12.7 +/- 3.5 vs 12.9 +/- 3.5, p=0.75). The acceptance rate of pregnant women with hepatitis B for antiviral therapy was 84.2%, while that of postpartum women was even higher. Logistic regression analysis showed that patients with positive hepatitis B e antigen (HBeAg) (OR, 3.35; 95% CI, 1.21 to 9.26) and higher scores on hepatitis B-related knowledge (OR, 3.52, 95% CI, 2.18 to 5.69) were more likely to accept antiviral therapy during pregnancy. Conclusions Pregnant women with hepatitis B in Zhejiang have heavy psychological stress and a high antiviral therapy acceptance rate during pregnancy. Acceptance is related to HBeAg status and level of understanding of hepatitis B during pregnancy. It is necessary to provide education on hepatitis B to reduce psychological stress and increase acceptance of antiviral therapy during pregnancy.