Effect of cesarean section on the risk of perinatal transmission of hepatitis C virus from HCV-RNA+/HIV- mothers: a meta-analysis.
BACKGROUND
Hepatitis C virus (HCV) vertical transmission is considered the main route of HCV infection in children. Some authors have stated that cesarean section (C/S) can reduce perinatal HCV transmission. However, the study findings are heterogeneous and high-quality studies are lacking.


OBJECTIVE
To evaluate the effect of mode of delivery on the risk of perinatal mother-to-infant transmission of HCV.


METHODS
Only the peer-reviewed published studies that compared perinatal transmission rate of HCV in elective or emergency cesarean section with vaginal delivery in HCV-RNA+/HIV- mothers were included. We applied the random effect model of DerSimonian and Laird method with heterogeneity and sensitivity analyses.


RESULTS
We identified 8 studies that involved 641 unique mother-infant pairs which fulfilled our inclusion criteria. Aggregation of study results did not show a significant decrease in HCV vertical transmission among study (mothers who underwent C/S) versus control (mothers who gave birth vaginally) patients [pooled odds ratio, 1.1 (95% CI 0.45-2.67)]. The P value was 0.35 for our test of heterogeneity.


CONCLUSIONS
Our meta-analysis suggests that C/S does not decrease perinatal HCV transmission from HCV-RNA+/HIV- mothers to infants.
Ghamar Chehreh
Mohammad Ebrahim
ME
Research Center for Gastroenterology and Liver Disease, University of Medical Sciences, Tehran, Iran.
Tabatabaei
Seyed Vahid
SV
Khazanehdari
Shahab
S
Alavian
Seyed Moayed
SM
D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D018023:HIV Seronegativity; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors
D012367:RNA, Viral