The impact of maternal chronic viral hepatitis infections on pregnancy and neonatal outcomes in in vitro fertilization: a systematic review and meta-analysis

BACKGROUND: Chronic hepatitis B (HBV) and hepatitis C (HCV) infections represent a substantial global health burden and increasing numbers of infertile women with chronic HBV/HCV infections seek conception through in vitro fertilization (IVF), raising clinical concerns regarding potential perinatal risks. OBJECTIVE: To investigate the association between maternal viral hepatitis status and pregnancy and neonatal outcomes in IVF populations. METHODS: English-language publications in databases including PubMed, Embase, Cochrane Library, and Web of Science Core Collection up to June 23, 2025 were systematically searched. Eligible study designs included cohort and case-control studies. Studies were excluded if they were not IVF populations. Two independent investigators performed study selection, extracted data and assess quality. The statistical synthesis employed fixed or random effects models based on study homogeneity. Potential publication bias was assessed through Begg’s rank correlation test and Egger’s linear regression test and methodological quality of these studies was evaluated using the Newcastle-Ottawa Scale. RESULTS: A total of 14 eligible studies (with 12 in HBV and 3 in HCV) were included for analysis. There were no significant associations between maternal HBV infection and live birth (OR: 1.017, 95%CI: 0.936–1.105), or clinical pregnancy (OR: 0.974, 95%CI: 0.863-1.100). An increased risk of preterm delivery was found among HBV-infected mothers (OR: 1.159, 95%CI: 1.022–1.315), while no associations were found in other pregnancy outcomes and neonatal outcomes. Similarly, HCV infection showed no significant correlations with live birth (OR: 0.618, 95%CI: 0.177–2.161), or clinical pregnancy (OR: 0.585, 95%CI: 0.276–1.241). CONCLUSIONS: Neither maternal HBV or HCV infection status was associated with pregnancy and neonatal outcomes in IVF populations, except increased preterm delivery in women with HBV infection. TRIAL REGISTRATION: PROSPERO registration number CRD420251079149.