Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection.
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.
Patra
Sharda
S
G.B. Pant Hospital and Lady Hardinge Medical College, New Delhi, India.
Kumar
Ashish
A
Trivedi
Shubha Sagar
SS
Puri
Manju
M
Sarin
Shiv Kumar
SK
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