[Prevalence and follow-up of hepatitis C virus infection in pregnancy]

Hepatitis C shows an increasing distribution in countries of western Europe. The aim of our study was to assess the prevalence of antibodies to hepatitis C (anti-HCV) in pregnancy, to evaluate the risk factors for anti-HCV positive women and the course of hepatitis C during pregnancy. 3712 pregnant patients of the university hospital Grosshadern, Munich, were analyzed for anti-HCV, anti-HIV and hepatitis B surface antigen. Anti-HCV seropositive women were further tested with western blot and polymerase chain reaction for HCV-RNA. Thirty-five (0.94%) of the 3712 pregnant women were found anti-HCV positive. 20% of them had present or previous injection drug abuse, hereof one patient had an associated seropositivity for HIV. Parenteral transmission through blood transfusion was likely in 11%. However, no parenteral exposure was recognized in 57% of the anti-HCV positive patients. The presence of serum HCV-RNA was detected in 16 (57%) of the 28 patients tested. In 17% (6/35) of the anti-HCV positive pregnancies elevated liver enzymes were noted, which did not show any significant change during the course of pregnancy. In conclusion, the prevalence of hepatitis C in pregnancy is relatively high with nearly 1%-comparable to chronic hepatitis B infection. Selected pregnancy screening based on perceived high-risk groups alone fail to detect about 60% of HCV antibody-positive women. Pregnancy did not influence the course of hepatitis C.