Pregnancy outcomes associated with viral hepatitis

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Hepatology

Background:

• Viral hepatitis, specifically hepatitis B virus (HBV) and hepatitis C virus (HCV), can pose risks during pregnancy.
• Understanding the specific contributions of HBV and HCV to pregnancy complications is crucial for maternal and fetal health.
• Previous research may not have fully elucidated the associations between viral hepatitis and a comprehensive range of pregnancy outcomes.

Purpose of the Study:

• To investigate the association between hepatitis B virus (HBV) and hepatitis C virus (HCV) and various pregnancy-related complications.
• To determine the specific risks posed by HBV, HCV, and their co-infection on conditions such as gestational diabetes mellitus (GDM), preterm birth (PTB), intrauterine growth restriction (IUGR), pre-eclampsia, antepartum haemorrhage, cholestasis, and caesarean delivery.
• To identify potential risk factors and inform clinical management strategies for pregnant women with viral hepatitis.

Main Methods:

• Utilized the Nationwide Inpatient Sample database, querying pregnancy-related discharges from 1995 to 2005.
• Employed logistic regression analysis to assess the association between HBV, HCV, and HBV+HCV co-infection with pregnancy complications.
• Controlled for covariates including maternal age, race, insurance status, substance use, and other medical conditions such as hypertension, HIV, anaemia, and sexually transmitted infections.

Main Results:

• Women with HBV showed an increased risk for preterm birth (aOR 1.65) and a decreased risk for caesarean delivery (aOR 0.686).
• Women with HCV had an increased risk for gestational diabetes mellitus (aOR 1.6).
• Individuals with HBV and HCV co-infection exhibited a significantly increased risk for antepartum haemorrhage (aOR 2.82); no association was found with IUGR or pre-eclampsia.

Conclusions:

• Hepatitis B and C infections are associated with an increased risk of adverse pregnancy outcomes.
• Specific viral hepatitis infections confer distinct risks, with HBV linked to PTB and HCV to GDM, while co-infection elevates antepartum haemorrhage risk.
• Further research is warranted to assess the efficacy and cost-effectiveness of counseling pregnant women with viral hepatitis regarding potential adverse outcomes.