title: Risk factors for vertical transmission of hepatitis C virus: a single center experience with 710 HCV-infected mothers.
abstract: OBJECTIVE
  The aim of this study was to analyze the risk factors on the perinatal transmission of hepatitis C virus (HCV).
  
  
  METHODS
  A retrospective cohort study with 711 infants born to 710 HCV-infected mothers was conducted at the Hospital La Fe, in Valencia, Spain, from 1986 to 2011. As potential risk factors for transmission we analyzed: maternal age, mode of acquisition of HCV infection, HIV co-infection, antiretroviral treatment against HIV, CD4 cell count, HIV and HCV viral load, liver enzyme levels during pregnancy, smoking habit, gestational age, intrapartum invasive procedures, length of rupture of membranes, length of labor, mode of delivery, episiotomy, birth weight, newborn gender and type of feeding.
  
  
  RESULTS
  Overall perinatal HCV transmission rate was 2.4%. The significant risk factors related with HCV transmission were maternal virus load >615copies/mL (OR 9.3 [95% CI 1.11-78.72]), intrapartum invasive procedures (OR 10.1 [95% CI 2.6-39.02]) and episiotomy (OR 4.2 [95% CI 1.2-14.16]). HIV co-infection and newborn female were near significance (p=0.081 and 0.075, respectively).
  
  
  CONCLUSIONS
  Invasive procedures as fetal scalp blood sampling or internal electrode and episiotomy increase vertical transmission of HCV, especially in patients with positive HCV RNA virus load at delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Universitari i Politècnic La Fe, Valencia, Spain; Department of Gynecology, Hospital Universitario Bellvitge-Idibell, Barcelona, Spain. Electronic address: agarciat@bellvitgehospital.cat.
authors.forename: Amparo
authors.initials: A
authors.lastname: Garcia-Tejedor
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Maiques-Montesinos
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
authors.forename: Vicente José
authors.initials: VJ
authors.lastname: Diago-Almela
authors.affiliation: Department of Pediatrics, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pereda-Perez
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Alberola-Cuñat
authors.affiliation: Department of Microbiology, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
authors.forename: José Luís
authors.initials: JL
authors.lastname: López-Hontangas
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Perales-Puchalt
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Universitari i Politècnic La Fe, Valencia, Spain; Facultad Medicina, Departamento Pediatría Obstetricia y Ginecología, Universidad Valencia, Spain.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Perales
mesh_terms: D000328:Adult; D060085:Coinfection / Q000150:complications; D004841:Episiotomy / Q000009:adverse effects; D005260:Female; D005323:Fetal Monitoring; D015658:HIV Infections / Q000150:complications*; D016174:Hepacivirus; D006526:Hepatitis C / Q000150:complications / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D036801:Parturition; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D019562:Viral Load
keywords: HCV; Perinatal care; Risk factors; Vertical transmission