Pregnancy and fetal outcomes of chronic hepatitis C mothers with viremia in China

Table 1 The demographic and clinical characteristics of mothers and infants

Variables presented with n (%), mean ± SD, or specified	HCV mothers with viremia (n = 79)1	Healthy mothers (n = 115)1	P value
Maternal characteristics
Age (yr)	25.8 ± 4.7	29.4 ± 4.9	< 0.001
< 20	2/79 (2.5)	0/115 (0.0)	0.003
20-34	73/79 (92.4)	94/115 (81.7)
≥ 35	4/79 (5.1)	21/115 (18.3)
Height, cm	159.6 ± 3.8	160.9 ± 4.0	0.02
Pre-pregnancy BMI	27.4 ± 3.4	27.5 ± 3.1	0.80
< 23	4/79 (5.1)	3/115 (2.6)	0.44
23-29	53/79 (67.1)	86/115 (74.8)
≥ 29	22/79 (27.8)	26/115 (22.6)
History of miscarriage	1/79 (1.3)	1/115 (0.9)	> 0.99
History of stillbirth	2/79 (2.5)	2/115 (1.7)	> 0.99
Previous uterine surgery	28/79 (35.4)	35/115 (30.4)	0.46
Parity
0-1	47/79 (59.5)	62/115 (53.9)	0.44
≥ 2	32/79 (40.5)	53/115 (46.1)
Plurality
0-1	47/79 (59.5)	62/115 (53.9)	0.44
> 2	32/79 (40.5)	53/115 (46.1)
Gestational (days)	273.8 ± 9.5	276.0 ± 9.1	0.11
Interspinous distance, median (IRQ), cm	25.0 (24.0, 25.0)	25.0 (24.0, 25.0)	0.23
Intercristal distance, median (IRQ), cm	27.0 (27.0, 28.0)	27.0 (27.0, 28.0)	0.40
External conjugate, median (IRQ), cm	20.0 (20.0, 21.0)	20.0 (20.0, 21.0)	0.33
Intertuberous diameter, median (IRQ), cm	8.5 (8.0, 8.5)	8.5 (8.0, 8.5)	0.006
< 8.5	38/79 (48.1)	34/115 (29.6)	0.009
≥ 8.5	41/79 (51.9)	81/115 (70.4)
Hemoglobin, median (IRQ), g/L	111.0 (100.0, 119.0)	110.0 (100.0, 119.0)	0.88
< 110	37/79 (46.8)	51/115 (44.3)	0.73
≥ 110	42/79 (53.2)	64/115 (55.7)
Platelet, median (IRQ), × 109/L	207.0 (166.0, 242.0)	201.0 (167.0, 242.0)	0.95
Prothrombin time, median (IRQ), seconds	10.6 (10.1, 11.1)	10.5 (10.0, 11.1)	0.40
ALT at delivery, U/L	26.3 ± 20.1	16.6 ± 56.7	0.15
HCV RNA at delivery, IU/mL	19, 217, 509 ± 35, 745, 723	-	-

¹All mothers in the study had a singleton pregnancy.

HCV: Hepatitis C virus; ALT: Alanine aminotransferase; IRQ: Interquartile range; BMI: Body mass index.

Table 2 Maternal outcomes in the hepatitis C virus viremic group vs the control group

Variables, n (%)	HCV-infected group (n = 79), %	Healthy mother group (n = 115), %	P value
Pregnancy complications
Preterm (< 37 wk)	1/79 (1.3)	0/115 (0.0)	> 0.99
Preeclampsia	3/79 (3.8)	0/115 (0.0)	0.07
Eclampsia	0/79 (0.0)	2/115 (2.5)	0.17
Gestational hypertension	0/79 (0.0)	4/115 (3.5)	0.15
Abnormal thyroid function	4/79 (5.1)	1/115 (0.9)	0.16
Gestational diabetes	4/79 (5.1)	4/115 (3.5)	0.72
Oligohydramnios	6/79 (7.6)	3/115 (2.6)	0.16
Abnormal renal function	49/79 (62.0)	64/115 (55.7)	0.38
Anemia during pregnancy	15/79 (19.0)	3/115 (2.6)	< 0.001
Obstetric complications
Rates of cesarean section1	38/79 (48.1)	32/115 (27.8)	0.004
Nuchal cord	27/79 (34.2)	11/115 (9.6)	< 0.001
Umbilical cord prolapses	1/79 (1.3)	0/115 (0.0)	0.41
Postpartum hemorrhage	1/79 (1.3)	0/115 (0.0)	0.41
Premature rupture of membranes	3/79 (3.8)	4/115 (3.5)	> 0.99

¹The rates of cesarean section were calculated based on the number of cases performed due to medical needs. Patients who requested a cesarean section without medical indications were not included.

Table 3 The fetal and infant outcomes in the two study groups

Infant characteristics at birth1 variables presented with n (%) or mean ± SD	Infants from HCV-infected mothers (n = 79)	Infants from healthy mothers (n = 115)	P value
Gestational weeks	39.1 ± 1.4	39.4 ± 1.3	0.11
Full-term birth	74/79 (93.7)	107/115 (93.0)	0.86
Meconium staining positive	8/79 (10.1)	11/115 (9.6)	> 0.99
Height at birth, cm	49.0 ± 1.6	49.4 ± 1.0	0.05
Head circumference, cm	33.1 ± 0.7	33.3 ± 0.6	0.03
Weight at birth, gms	3105.1 ± 459.4	3278.3 ± 462.0	0.006
≤ 3250 gms	49/79 (62.0)	52/115 (45.2)	0.02
< 2500 gms	7/79 (8.9)	4/115 (3.5)	0.20
Small for gestational age2	1/79 (1.3)	1/115 (0.9)	> 0.99
Birth defects	0/79 (0.0)	0/115 (0.0)	> 0.99
Apgar score < 7 at 5 min	0/79 (0.0)	0/115 (0.0)	> 0.99
HCV-Ab (+) at birth, n (%)	79/79 (100)	-	-
Detectable HCV RNA, n (%)	1/79 (1.27)	-	-

¹All cases in the study were singleton.

²Small for gestational age; defined as a birth weight below the 10^th percentile for each gestational age using sex-specific criteria.

HCV: Hepatitis C virus.

Table 4 Risk factors associated with obstetric complications

Clinical variables	Case/exposed1	Crude OR (95%CI); P value	Adjusted OR (95%CI); P value
C-section2
Age, n (%)
< 35	59/194 (30.4)	1	1
≥ 35	11/194 (5.7)	1.5 (0.6-3.4); P = 0.38	1.5 (0.6-3.9); P = 0.42
Nulliparity, n (%)
No	37/194 (19.1)	1	1
Yes	33/194 (17.0)	0.6 (0.3-1.0); P = 0.06	0.6 (0.3-1.1); P = 0.08
BMI, n (%)
< 30	57/194 (29.4)	1	1
≥ 30	13/194 (6.7)	1.3 (0.6-2.7); P = 0.56	1.2 (0.5-2.7); P = 0.65
HCV infection, n (%)
No	32/194 (16.5)	1	1
Yes	38/194 (19.6)	2.4 (1.3-4.4); P = 0.004	2.6 (1.4-4.9); P = 0.003
Intertuberous diameter, n (%)
≥ 8.5	41/194 (21.1)	1	1
< 8.5	29/194 (14.9)	1.3 (0.7-2.2); P = 0.41	2.6 (1.4-4.9); P = 0.65
Nuchal cord
Age, n (%)
< 35	33/194 (17.0)	1	1
≥ 35	5/194 (2.6)	1.0 (0.4-2.9); P = 0.96	2.8 (0.8-10.3); P = 0.11
Nulliparity, n (%)
No	13/194 (6.7)	1	1
Yes	25/194 (12.9)	1.6 (0.8-3.5); P = 0.19	2.0 (0.9-4.8); P = 0.11
BMI, n (%)
< 30	32/194 (16.5)	1	1
≥ 30	6/194 (3.1)	0.9 (0.4-2.5); P = 0.90	0.7 (0.2-1.9); P = 0.44
HCV infection, n (%)
No	11/194 (5.7)	1	1
Yes	27/194 (13.9)	4.9 (2.3-10.7); P < 0.001	5.6 (2.4-13.0); P < 0.001
Intertuberous diameter, n (%)
≥ 8.5	20/194 (10.3)	1	1
< 8.5	18/194 (9.3)	1.3 (0.7-2.4); P = 0.35	1.3 (0.6-2.8); P = 0.51
Maternal anemia during pregnancy
Age, n (%)
< 35	19/194 (9.8)	1	1
≥ 35	3/194 (1.5)	1.1 (0.3-3.9); P = 0.91	2.5 (0.5-13.3); P = 0.28
Nulliparity, n (%)
No	13/194 (6.7)	1	1
Yes	9/194 (4.6)	0.5 (0.2-1.2); P = 0.13	0.5 (0.2-1.4); P = 0.18
BMI, n (%)
< 30	20/194 (10.3)	1	1
≥ 30	2/194 (1.0)	0.5 (0.1-2.1); P = 0.33	0.4 (0.1-1.8); P = 0.21
HCV infection, n (%)
No	3/194 (1.5)	1	1
Yes	19/194 (9.8)	11.8 (3.4-41.6); P < 0.001	18.1 (4.3-76.6); P < 0.001
Intertuberous diameter, n (%)
≥ 8.5	13/194 (6.7)	1	1
< 8.5	9/194 (4.6)	1.2 (0.5-3.0); P = 0.35	0.8 (0.3-2.3); P = 0.72

¹Case/exposed: The case refers to the number of patients who presented with the specified variable and the Exposed refers to the total number of patients in the entire study cohort.

²The rates of cesarean section were calculated based on the number of cases performed due to medical needs. Patients who requested a cesarean section without medical indications were not included.

BMI: Body mass index; OR: Odds ratio; HCV: Hepatitis C virus.

Table 5 Risk factors associated with fetal negative outcomes

Clinical variables	Case/exposed1	Crude OR (95%CI)	Adjusted OR (95%CI)
Head circumference ≤ 33 cm at birth
Maternal age, n (%)
< 35	118 /194 (60.8)	1	1
≥ 35	18 /194 (9.3)	1.1 (0.4-2.8); P = 0.82	2.0 (0.7-5.7); P = 0.19
Nulliparity, n (%)
No	53/194 (27.3)	1	1
Yes	83 /194 (42.8)	1.9 (1.0-3.6); P = 0.04	2.4 (1.2-4.9); P = 0.01
BMI, n (%)
< 30	120/194 (61.9)	1	1
≥ 30	16/194 (8.2)	0.4 (0.2-0.8); P = 0.008	0.3 (0.1-0.7); P = 0.003
HCV infection, n (%)
No	75/194 (38.7)	1	1
Yes	61/194 (31.4)	1.8 (0.9-3.5); P = 0.08	2.1 (1.1-4.3); P = 0.03
Intertuberous diameter, n (%)
≥ 8.5	85/194 (43.8)	1	1
< 8.5	51/194 (26.3)	1.1 (0.6-2.0); P = 0.86	1.0 (0.5-2.0); P = 0.75
Weight at birth ≤ 3250 gms
Age, n (%)
< 35	88/194 (45.4)	1	1
≥ 35	13/194 (6.7)	1.0 (0.4-2.3); P > 0.99	1.7 (0.6-4.3); P = 0.29
Nulliparity, n (%)
No	39/194 (20.1)	1	1
Yes	62/194 (32.0)	1.6 (0.9-2.8); P = 0.13	1.8 (0.9-3.4); P = 0.07
BMI, n (%)
< 30	88/194 (45.4)	1	1
≥ 30	13 /194 (6.7)	0.6 (0.3-1.2); P = 0.16	0.5 (0.2-1.1); P = 0.09
HCV infection HCV, n (%)
No	52/194 (26.8)	1	1
Yes	49/194 (25.3)	2.0 (1.1-3.5); P = 0.02	2.2 (1.2-4.0); P = 0.01
Intertuberous diameter, n (%)
≥ 8.5	61/194 (31.4)	1	1
< 8.5	40/194 (20.6)	1.2 (0.7-2.2); P = 0.46	1.1 (0.6-2.1); P = 0.66

¹Case/exposed: The case refers to the number of patients who presented with the specified variable and the Exposed refers to the total number of patients in the entire study cohort.

BMI: Body mass index; OR: Odds ratio.