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Prediction of Hepatitis C Virus Perinatal Transmission in Pregnant Individuals With Hepatitis C Virus Infection

Grecio J Sandoval1, George R Saade, Brenna L Hughes

  • 1Departments of Obstetrics and Gynecology, The Ohio State University, Columbus, and Case Western Reserve University, Cleveland, Ohio, University of Texas Medical Branch, Galveston, University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, University of Texas Southwestern Medical Center, Dallas, and University of Texas at Austin, Austin, Texas, Brown University, Providence, Rhode Island, University of Alabama at Birmingham, Birmingham, Alabama, University of North Carolina at Chapel Hill, Chapel Hill, and Duke University, Durham, North Carolina, University of Utah Health Sciences Center, Salt Lake City, Utah, Columbia University, New York, New York, Boston Medical Center, Boston, Massachusetts, University of Pittsburgh, Pittsburgh, and University of Pennsylvania, Philadelphia, Pennsylvania, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, Northwestern University, Chicago, Illinois, and Stanford University, Stanford, California; and the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.

Obstetrics and Gynecology
|February 27, 2025
PubMed

Our objective was to develop a prediction model for hepatitis C virus (HCV) infection perinatal transmission to improve triage for neonatal follow-up. This was a secondary analysis of HCV antibody-positive participants who were enrolled in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network multicenter observational study of HCV infection in pregnancy. Among 432 participants, the perinatal transmission rate was 6.0% (95% CI, 4.0-8.7%). The prediction model was developed and included two factors: maternal HCV RNA titer greater than 10 6 international units/mL and having had any antepartum bleeding. Using this model, the area under the curve for perinatal transmission was 0.76 (95% CI, 0.67-0.86). Probabilities of perinatal transmission of HCV infection ranged from 1.5% (a pregnant individual with HCV RNA 10 6 international units/mL or less and no antepartum bleeding) to 28.5% (a pregnant individual with an HCV RNA titer greater than 10 6 international units/mL and antepartum bleeding). Our results provide data to aid in clinical counseling of pregnant individuals with positive HCV antibodies. Additional research is needed to externally validate this prediction model.

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