Maternal HCV Infection Tied to Adverse Neonatal Outcomes


SAN DIEGO — In pregnancy, maternal hepatitis C virus infection may have a negative impact on both maternal and neonatal health, results from a population-based study in Washington State demonstrated.

“Further prospective studies are needed, but I think this brings up the question of whether screening needs to be reevaluated in pregnant women,” Dr. Steven Pergam said at the annual meeting of the Infectious Diseases Society of America.

“Current recommendations by the American College of Obstetricians and Gynecologists and the Centers for Disease Control and Prevention have recommended screening high-risk patients. This is based mainly on the risk of perinatal transmission. Universal screening has been modeled in a number of studies and it has not been felt to be cost effective,” Dr. Pergam added.

He and his colleagues used Washington State singleton birth records and Comprehensive Hospital Abstract Reporting System data from 2003–2005 to identify hepatitis C virus (HCV) infection in mothers. “HCV information was added to the Washington State birth database in 2003, providing us a great opportunity to look at some of these outcomes,” said Dr. Pergam, a fellow in infectious diseases at the University of Washington, Seattle.

The researchers matched HCV-positive mothers in a ratio of 1:4 with HCV-negative mothers who were randomly selected from the same data set and evaluated maternal and neonatal outcomes associated with HCV.

Of the 240,131 singleton births studied, 506 were born to HCV-positive mothers with a mean age of 30 years and were matched with 2,022 born to HCV-negative mothers with a mean age of 28 years.

HCV-positive mothers who had excess weight gain during pregnancy, according to Institute of Medicine Guidelines, were 2.5 times more likely than their HCV-negative counterparts to develop gestational diabetes.

Compared with infants born to HCV-negative mothers, infants born to HCV-positive mothers were 2.2 times more likely to have low birth weight, 1.5 times more likely to be small for gestational age, 2.8 times more likely to require neonatal intensive care unit admission, and 2.4 times more likely to require assisted ventilation.

A subanalysis of infants born to 124 drug-using HCV-positive mothers revealed that the adverse outcomes of low birth weight, and being small for gestational age fall out as associated adverse outcomes. “It's not surprising that drug use would be a driving factor in these issues,” he said.

'I think this brings up the question of whether screening needs to be reevaluated in pregnant women.' DR. PERGAM

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