Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 14, 2022; 28(34): 5023-5035
Published online Sep 14, 2022. doi: 10.3748/wjg.v28.i34.5023
Pregnancy and fetal outcomes of chronic hepatitis C mothers with viremia in China
Calvin Q Pan, Bao-Shen Zhu, Jian-Ping Xu, Jian-Xia Li, Li-Juan Sun, Hong-Xia Tian, Xi-Hong Zhang, Su-Wen Li, Er-Hei Dai
Calvin Q Pan, Center for Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Calvin Q Pan, Division of Gastroenterology and Hepatology, Department of Medicine, NYU Langone Health, NYU School of Medicine, Flushing, NY 11355, United States
Bao-Shen Zhu, Jian-Ping Xu, Jian-Xia Li, Li-Juan Sun, Hong-Xia Tian, Su-Wen Li, Department of Obstetrics and Gynecology, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang 050021, Hebei Province, China
Xi-Hong Zhang, School of Public Health, North China University of Science and Technology, Tangshan 063210, Hebei Province, China
Xi-Hong Zhang, Er-Hei Dai, Division of Liver Disease, Department of Medicine, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang 050021, Hebei Province, China
Author contributions: Pan CQ provided the concept and designed the study, wrote the manuscript, communicated with the journal, and addressed comments from reviewers; Dai EH and Zhu BS obtained the funding and supervised the study; Pan CQ, Zhang XH, and Dai EH performed data analyses; All other authors contributed to the data collection.
Supported by The Ministry of Science and Technology of China for the National Five-Year Key Projects in Infectious Diseases, No. 2015ZX10004801.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the Fifth Hospital of Shijiazhuang in China.
Informed consent statement: The informed consent was waived.
Conflict-of-interest statement: Dr. Pan received grants from Gilead. He also serves as a speaker for Gilead and Abbvie. Other authors have nothing to be disclosed.
Data sharing statement: The authors agree to share anonymized Individual Patient Data (IPD) upon request or as required by law and/or regulation with qualified external researchers. Approval of such requests is at the authors’ discretion and is dependent on the nature of the request, the merit of the research proposed, the availability of the data, and the intended use of the data. Data requests should be sent to Erhei Dai MD at email:
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Er-Hei Dai, MD, Professor, Division of Liver Disease, Department of Medicine, The Fifth Hospital of Shijiazhuang, Hebei Medical University, No. 42 Ta’nan Road, Yuhua Distinct, Shijiazhuang 050021, Hebei Province, China.
Received: May 24, 2022
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
Research background

Hepatitis C virus (HCV) infection remains a significant global health burden, and there is a high proportion of women with antibodies to HCV positive whose active infection with viremia. In addition, HCV infection among pregnant women is an increasing but potentially modifiable threat to maternal and child health.

Research motivation

Although HCV affects a significant number of pregnant women, there is limited data regarding the impact of HCV active infection on pregnancy and infant outcomes. Therefore, there are data gaps in supporting strategies for clinical management of mothers with HCV infections during pregnancy.

Research objectives

We conducted a retrospective cohort study to compare the frequency and severity of adverse maternal outcomes during pregnancy, as well as fetal and infant outcomes between mothers with HCV viremia and healthy mothers.

Research methods

A retrospective observational cohort study was conducted to compare pregnancy and fetal outcomes of HCV-viremic mothers with those of healthy mothers. After HCV mothers with viremia and healthy mothers were enrolled, we collected their demographic information and pertinent clinical data using an electronic medical record system and paper charts. Perinatal information for fetal development and infant outcomes were extracted from the neonatal records. Data analyses were performed using the Statistical Package for Social Science for Windows, Version 25.0 (SPSS Inc., IBM, New York, United States).

Research results

Our study enrolled 79 viremic mothers and 115 healthy mothers. Compared to healthy mothers, HCV mothers had a significantly higher frequency of anemia, caesarian section, and nuchal cords during pregnancy. In addition, the mean neonatal weight and head circumference in the HCV group was significantly lower. In a multivariate model, similar results were found.

Research conclusions

Our study demonstrates the association between maternal HCV viremia and a smaller neonate head circumference. We also confirmed the high frequency of pregnancy and obstetric complications in HCV viremic mothers.

Research perspectives

Multi-center and large sample studies are needed to verify these results in the future and to investigate if HCV-infected patients with advanced fibrosis have negative maternal and fetal outcomes.