title: Obstetric management of hepatitis C-positive mothers: analysis of vertical transmission in 559 mother-infant pairs.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, National Maternity Hospital, University College Dublin School of Medicine and Medical Science, Dublin, Ireland.
authors.forename: Moya B
authors.initials: MB
authors.lastname: McMenamin
authors.forename: Abigail D
authors.initials: AD
authors.lastname: Jackson
authors.forename: John
authors.initials: J
authors.lastname: Lambert
authors.forename: William
authors.initials: W
authors.lastname: Hall
authors.forename: Karina
authors.initials: K
authors.lastname: Butler
authors.forename: Sam
authors.initials: S
authors.lastname: Coulter-Smith
authors.forename: Fionnuala M
authors.initials: FM
authors.lastname: McAuliffe
mesh_terms: 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
chemical_list: D012367:RNA, Viral