title: Maternal hepatitis B virus or hepatitis C virus carrier status as an independent risk factor for adverse perinatal outcome.
abstract: OBJECTIVE
  To examine the impact of maternal hepatitis B virus (HBV) or hepatitis C virus (HCV) carrier status on pregnancy outcomes.
  
  
  METHODS
  A population-based study was performed by comparing all pregnancies of HBsAg and/or anti-HCV seropositive women who delivered during the years 1988-2007 with all other pregnant women who delivered in the same period. Multivariable logistic regression models were constructed to control for confounders.
  
  
  RESULTS
  Seven hundred and forty-nine hepatitis seropositive pregnant women were identified out of 186 619 deliveries (0.4%). Maternal characteristics, as well as perinatal outcomes, were comparable between the HBV and HCV carriers. HBV/HCV carriers had higher rates of preterm deliveries (<37 weeks gestation; 11.5 vs. 7.9%, P<0.001), premature rupture of membranes (8.9 vs. 6.9%, P=0.026), placental abruption (1.5 vs. 0.7%, P=0.018), labour induction (33.9 vs. 28.1%, P<0.001) and Caesarean deliveries (19.0 vs. 13.2%, P<0.001). Higher rates of perinatal mortality (2.3 vs. 1.3%, P=0.016), congenital malformations (7.2 vs. 5.1%, P=0.01) and low birth weight (<2500 kg; 10.4 vs. 7.8%, P=0.009) were noted in newborns of hepatitis carriers compared with the control group. Controlling for possible confounders such as maternal age and parity by using multivariable analyses, the significant association between HBV or HCV carrier status and perinatal mortality, congenital malformations and low birth weight remained significant.
  
  
  CONCLUSIONS
  Maternal HBV or HCV carrier status is an independent risk factor for adverse perinatal outcome and careful surveillance is warranted.
authors.affiliation: The Joyce and Irving Goldman Medical School, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er-Sheva, Israel.
authors.forename: Ari
authors.initials: A
authors.lastname: Safir
authors.forename: Amalia
authors.initials: A
authors.lastname: Levy
authors.forename: Emanuel
authors.initials: E
authors.lastname: Sikuler
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000293:Adolescent; D000328:Adult; D002353:Carrier State; D000013:Congenital Abnormalities / Q000209:etiology*; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D047928:Premature Birth / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors