Pregnancy and pregnancy outcome in hepatitis C type 1b.
A large cohort of rhesus-negative women in Ireland were inadvertently infected with hepatitis C virus following exposure to contaminated anti-D immunoglobulin in 1977-8. This major iatrogenic episode was discovered in 1994. We studied 36 women who had been infected after their first pregnancy, and compared them to an age- and parity-matched control group of rhesus-positive women. The presence of hepatitis C antibody was confirmed in all 36 by enzyme-linked immunosorbent assay and by recombinant immunoblot assay, while 26 (72%) of the cohort were HCV-RNA-positive (type 1b) on PCR testing. In the 20 years post-infection, all members of the study group had at least one pregnancy, and mean parity was 3.5. They had a total of 100 pregnancies and 85 of these went to term. There were four premature births, one being a twin pregnancy, and 11 spontaneous miscarriages. One miscarriage occurred in the pregnancy following HCV infection. There were two neonatal deaths due to severe congenital abnormalities in the PCR-positive women. Of the children born to HCV-RNA positive mothers, only one (2.3%) tested positive for the virus. Significant portal fibrosis on liver biopsy was confined to HCV-RNA-positive mothers apart from one single exception in the antibody-positive HCV-RNA-negative group. Comparison with the control group showed no increase in spontaneous miscarriage rate, and no significant difference in obstetric complications; birth weights were similar for the two groups.
Jabeen
T
T
Departments of Medicine, Pathology, and Statistics, Cork University Hospital, and University College Cork, Cork, Ireland.
Cannon
B
B
Hogan
J
J
Crowley
M
M
Devereux
C
C
Fanning
L
L
Kenny-Walsh
E
E
Shanahan
F
F
Whelton
M J
MJ
D000328:Adult; D016022:Case-Control Studies; D000013:Congenital Abnormalities; D005260:Female; D005313:Fetal Death; D005355:Fibrosis; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic; D006801:Humans; D007049:Iatrogenic Disease; D007231:Infant, Newborn; D007234:Infant, Premature; D018445:Infectious Disease Transmission, Vertical; D008099:Liver / Q000473:pathology; D010298:Parity; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012367:RNA, Viral / Q000097:blood; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012203:Rh Isoimmunization / Q000628:therapy; D018029:Rho(D) Immune Globulin / Q000008:administration & dosage; D014427:Twins
D012367:RNA, Viral; D018029:Rho(D) Immune Globulin