Obstetric management of hepatitis C-positive mothers: analysis of vertical transmission in 559 mother-infant pairs.
OBJECTIVE
The objective of the study was to determine vertical transmission rates of hepatitis C in 2 tertiary level maternity units.


METHODS
This was a retrospective review of all hepatitis C-positive mothers and their pregnancy outcomes.


RESULTS
Of 74,629 deliveries, 559 liveborn infants were born to 545 hepatitis C mothers; the rate of antenatal hepatitis C infection was 0.7%. In the neonatal period, 423 infants tested negative for hepatitis C ribonucleic acid (RNA) (75.7%), 18 were positive (3.2%), and 118 infants were not tested or were lost to follow-up (21.1%). The overall vertical transmission rate is 18 of 441 (4.1%, 95% confidence interval 2.3% to 5.9%). The vertical transmission rate for infants following vaginal delivery or emergency cesarean in labor was no different when compared with those delivered by planned cesarean (4.2% vs 3.0%, P = NS). Among women in whom hepatitis C RNA was detected antenatally, this finding remained (7.2% vs 5.3%, P = NS). No case of vertical transmission was noted among hepatitis C RNA-negative mothers.


CONCLUSIONS
This study reports a vertical transmission rate for hepatitis C of 4.1%. These results do not support a recommendation of planned cesarean to reduce vertical transmission of hepatitis C infection.
McMenamin
Moya B
MB
Department of Obstetrics and Gynaecology, National Maternity Hospital, University College Dublin School of Medicine and Medical Science, Dublin, Ireland.
Jackson
Abigail D
AD
Lambert
John
J
Hall
William
W
Butler
Karina
K
Coulter-Smith
Sam
S
McAuliffe
Fionnuala M
FM
D000328:Adult; D002585:Cesarean Section; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000453:epidemiology* / Q000628:therapy / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control / Q000706:statistics & numerical data*; D009035:Mothers; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000628:therapy*; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D012307:Risk Factors; D014766:Viremia / Q000453:epidemiology
D012367:RNA, Viral