Published online Sep 14, 2022. doi: 10.3748/wjg.v28.i34.5023
Peer-review started: May 24, 2022
First decision: June 27, 2022
Revised: July 9, 2022
Accepted: August 25, 2022
Article in press: August 25, 2022
Published online: September 14, 2022
Data that assess maternal and infant outcomes in hepatitis C virus (HCV)-infected mothers are limited.
To investigate the frequency of complications and the associated risk factors.
We performed a cohort study to compare pregnancy and fetal outcomes of HCV-viremic mothers with those of healthy mothers. Risk factors were analyzed with logistic regression.
Among 112 consecutive HCV antibody-positive mothers screened, we enrolled 79 viremic mothers. We randomly selected 115 healthy mothers from the birth registry as the control. Compared to healthy mothers, HCV mothers had a significantly higher frequency of anemia [2.6% (3/115) vs 19.0% (15/79), P < 0.001] during pregnancy, medical conditions that required caesarian section [27.8% (32/115) vs 48.1% (38/79), P = 0.004], and nuchal cords [9.6% (11/115) vs 34.2% (27/79), P < 0.001]. In addition, the mean neonatal weight in the HCV group was significantly lower (3278.3 ± 462.0 vs 3105.1 ± 459.4 gms; P = 0.006), and the mean head circumference was smaller (33.3 ± 0.6 vs 33.1 ± 0.7 cm; P = 0.03). In a multivariate model, HCV-infected mothers were more likely to suffer anemia [adjusted odds ratio (OR): 18.1, 95% confidence interval (CI): 4.3-76.6], require caesarian sections (adjusted OR: 2.6, 95%CI: 1.4-4.9), and have nuchal cords (adjusted OR: 5.6, 95%CI: 2.4-13.0). Their neonates were also more likely to have smaller head circumferences (adjusted OR: 2.1, 95%CI: 1.1-4.3) and lower birth weights than the average (≤ 3250 gms) with an adjusted OR of 2.2 (95%CI: 1.2-4.0). The vertical transmission rate was 1% in HCV-infected mothers.
Maternal HCV infections may associate with pregnancy and obstetric complications. We demonstrated a previously unreported association between maternal HCV viremia and a smaller neonatal head circumference, suggesting fetal growth restriction.
Core Tip: Although hepatitis C virus (HCV) affects a significant number of pregnant women, there is limited data regarding the impact of HCV active infection on pregnancy and infant outcomes. The current cohort study compared maternal complications and fetal development of HCV mothers with detectable levels of HCV RNA with those of healthy mothers. The study demonstrates a previously unreported association between maternal HCV viremia and a smaller neonate head circumference. In addition, HCV viremia was an independent predictor for negative maternal outcomes including anemia during pregnancy, medical conditions that required caesarian section, and nuchal cords. These findings increase the need for close antenatal surveillance in HCV mothers with viremia for maternal complications and delayed fetal development.