title: Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection.
abstract: BACKGROUND
  Hepatitis E virus (HEV) infection is known to cause severe liver disease in pregnant women. It is unclear whether obstetric and fetal outcomes are worse in pregnant women with HEV infection than in women with other forms of viral hepatitis.
  
  
  OBJECTIVE
  To compare maternal, obstetric, and fetal outcomes in pregnant women with acute viral hepatitis caused by HEV and other hepatitis viruses.
  
  
  METHODS
  Observational cohort.
  
  
  METHODS
  Tertiary care hospital, New Delhi, India.
  
  
  METHODS
  220 consecutive pregnant women presenting with jaundice caused by acute viral hepatitis.
  
  
  METHODS
  Maternal mortality and medical complications, obstetric complications, deliveries, and fetal outcomes.
  
  
  RESULTS
  Infection with HEV caused acute viral hepatitis in 60% of included women. Fulminant hepatic failure was more common (relative risk, 2.7 [95% CI, 1.7 to 4.2]; P = 0.001) and maternal mortality was greater (relative risk, 6.0 [CI, 2.7 to 13.3]; P < 0.001) in HEV-infected women than in non-HEV-infected women. Women with HEV infection were more likely than those with other forms of viral hepatitis to have obstetric complications (relative risk, 4.1 [CI, 1.7 to 10.2] for antepartum hemorrhage and 1.9 [CI, 1.3 to 2.7] for intrauterine fetal death; P < 0.001 for both) and poor fetal outcomes (relative risk, 1.2 [CI, 1.0 to 1.4] for preterm delivery [P = 0.005] and 1.8 [CI, 1.2 to 2.5] for stillbirth [P = 0.026]).
  
  
  CONCLUSIONS
  The findings may not apply to community settings, to women who are asymptomatic or have only minor symptoms, or in the setting of an HEV epidemic.
  
  
  CONCLUSIONS
  Pregnant women with jaundice and acute viral hepatitis caused by HEV infection had a higher maternal mortality rate and worse obstetric and fetal outcomes than did pregnant women with jaundice and acute viral hepatitis caused by other types of viral hepatitis.
authors.affiliation: G.B. Pant Hospital and Lady Hardinge Medical College, New Delhi, India.
authors.forename: Sharda
authors.initials: S
authors.lastname: Patra
authors.forename: Ashish
authors.initials: A
authors.lastname: Kumar
authors.forename: Shubha Sagar
authors.initials: SS
authors.lastname: Trivedi
authors.forename: Manju
authors.initials: M
authors.lastname: Puri
authors.forename: Shiv Kumar
authors.initials: SK
authors.lastname: Sarin
mesh_terms: D000328:Adult; D005260:Female; D005313:Fetal Death; D006470:Hemorrhage / Q000209:etiology; D016751:Hepatitis E / Q000150:complications*; D006801:Humans; D007565:Jaundice / Q000209:etiology; D017114:Liver Failure, Acute / Q000209:etiology; D008428:Maternal Mortality; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011256:Pregnancy Outcome; D011446:Prospective Studies; D050497:Stillbirth