title: Reducing risk for mother-to-infant transmission of hepatitis C virus: a systematic review for the U.S. Preventive Services Task Force.
abstract: BACKGROUND
  Mother-to-infant transmission is the leading cause of childhood hepatitis C virus (HCV) infection, with up to 4000 new cases each year in the United States.
  
  
  OBJECTIVE
  To evaluate effects of mode of delivery, labor management strategies, and breastfeeding practices on risk for mother-to-infant transmission of HCV.
  
  
  METHODS
  MEDLINE (1947 to May 2012), the Cochrane Library Database, clinical trial registries, and reference lists.
  
  
  METHODS
  Randomized trials and observational studies on mode of delivery, labor management strategies, and breastfeeding practices and risk for mother-to-infant transmission of HCV.
  
  
  METHODS
  Investigators abstracted and reviewed study details and quality using predefined criteria.
  
  
  RESULTS
  Eighteen observational studies evaluated the association between mode of delivery, labor management strategies, or breastfeeding practices and risk for mother-to-infant HCV transmission. Fourteen studies (2 good-quality, 4 fair-quality, and 8 poor-quality studies) found no clear association between mode of delivery (vaginal versus cesarean delivery) and risk for transmission. Two studies (1 good-quality and 1 poor-quality study) reported an association between prolonged duration of ruptured membranes and increased risk for transmission. Fourteen studies (2 good-quality, 2 fair-quality, and 10 poor-quality studies) found no association between breastfeeding and risk for transmission.
  
  
  CONCLUSIONS
  Only English-language articles were included. Studies were observational, and most had important methodological shortcomings, including failure to adjust for potential confounders and small sample sizes.
  
  
  CONCLUSIONS
  No intervention has been clearly demonstrated to reduce the risk for mother-to-infant HCV transmission. Avoidance of breastfeeding does not seem to be indicated for reducing transmission risk.
  
  
  BACKGROUND
  Agency for Healthcare Research and Quality.
authors: Oregon Health & Science University, Portland, USA.
authors: Erika Barth
authors: EB
authors: Cottrell
authors: Roger
authors: R
authors: Chou
authors: Ngoc
authors: N
authors: Wasson
authors: Basmah
authors: B
authors: Rahman
authors: Jeanne-Marie
authors: JM
authors: Guise
mesh_terms: D001942:Breast Feeding; D036861:Delivery, Obstetric; D005260:Female; D005323:Fetal Monitoring; D006526:Hepatitis C / Q000635:transmission*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007743:Labor, Obstetric; D018743:Perinatal Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control; D040242:Risk Reduction Behavior