title: Maternal hepatitis B and hepatitis C infection and neonatal neurological outcomes.
abstract: To examine the associations between maternal hepatitis B (HBV) and hepatitis C (HCV) infection status and selected infant neurological outcomes diagnosed at birth, we conducted a population-based, retrospective cohort study on singleton live births in Florida from 1998 to 2009. Primary exposures included maternal HBV and HCV monoinfection. The neurological outcomes included brachial plexus injury, cephalhematoma, foetal distress, feeding difficulties, intraventricular h aemorrhage and neonatal seizures. Multivariable logistic regression models were used to generate odds ratios (OR) and 95% confidence intervals (CI) that were adjusted for socio-demographic characteristics, risky behaviours, pregnancy complications and pre-existing medical conditions, and timing of delivery. The risk of an adverse neurological outcome was higher in infants born to mothers with hepatitis viral infection (7.2% for HCV, 5.0% for HBV), compared with infants of hepatitis virus-free mothers (4.2%). After adjusting for potential confounders, women with HBV were twice as likely to have infants who suffered from brachial plexus injury (OR = 2.04, 95% CI = 1.15-3.60), while those with HCV had an elevated odds of having an infant with feeding difficulties (OR: 1.32, 95% CI = 1.06-1.64) and a borderline increased likelihood for neonatal seizures (OR = 1.74, 95% CI = 0.98-3.10). Additionally, HCV+ mothers had a 22% increased odds of having an infant with some type of adverse neurological outcome (OR: 1.22, 95% CI = 1.03-1.44). Our findings add to current understanding of the association between maternal HBV/HCV infections and infant neurological outcomes. Further research evaluating the role of maternal HBV and HCV infections (including viraemia, treatment) on pregnancy outcomes is warranted.
authors.affiliation: Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Salemi
authors.forename: V E
authors.initials: VE
authors.lastname: Whiteman
authors.forename: E M
authors.initials: EM
authors.lastname: August
authors.forename: K
authors.initials: K
authors.lastname: Chandler
authors.forename: A K
authors.initials: AK
authors.lastname: Mbah
authors.forename: H M
authors.initials: HM
authors.lastname: Salihu
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005431:Florida / Q000453:epidemiology; D006509:Hepatitis B / Q000150:complications* / Q000453:epidemiology*; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D015233:Models, Statistical; D009422:Nervous System Diseases / Q000453:epidemiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult
keywords: hepatitis B; hepatitis C; infections; neurological outcomes; pregnancy; women