Increased Risk of Mother-to-Infant Transmission of Hepatitis C Virus by Intrapartum Infantile Exposure to Maternal Blood

Virological and clinical data from 73 hepatitis C virus (HCV)–infected pregnant women who gave birth to 75 children were merged retrospectively, by logistic regression analysis, to investigate risk factors for vertical transmission of HCV. Eighty-two percent of the HCV-infected mothers were HCV-RNA–...

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Bibliographic Details
Published in:The Journal of infectious diseases 2003-02, Vol.187 (3), p.345-351
Main Authors: Steininger, Christoph, Kundi, Michael, Jatzko, Gerlinde, Kiss, Herbert, Lischka, Andreas, Holzmann, Heidemarie
Format: Article
Language:English
Subjects:
Biological and medical sciences
Children
Disease transmission
Female
Fetal Blood - virology
Follow-Up Studies
Hepacivirus
Hepacivirus - genetics
Hepacivirus - isolation & purification
Hepatitis C - blood
Hepatitis C - complications
Hepatitis C - prevention & control
Hepatitis C - transmission
HIV
HIV - genetics
HIV - isolation & purification
HIV Infections - blood
HIV Infections - complications
HIV Infections - prevention & control
HIV Infections - transmission
Human viral diseases
Humans
Hydrogen-Ion Concentration
Infant, Newborn
Infections
Infectious Disease Transmission, Vertical
Infectious diseases
Logistic Models
Medical sciences
Mothers
Parturition - blood
Predisposing factors
Pregnancy
Pregnancy Complications, Infectious - blood
Pregnancy Complications, Infectious - virology
Retrospective Studies
Risk Factors
RNA
RNA, Viral - blood
Vertical disease transmission
Viral diseases
Viral hepatitis
Viral Load
Viruses
Women
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Summary:Virological and clinical data from 73 hepatitis C virus (HCV)–infected pregnant women who gave birth to 75 children were merged retrospectively, by logistic regression analysis, to investigate risk factors for vertical transmission of HCV. Eighty-two percent of the HCV-infected mothers were HCV-RNA–positive during pregnancy, and 10% were coinfected with human immunodeficiency virus (HIV). Nine children were HCV infected, 1 was HIV infected, but none was HIV-HCV coinfected. Among vaginal deliveries, the mean HCV load of mothers who transmitted HCV to their infants was higher than that of those who did not (8.1×105 vs. 1.4×104 copies/mL; P=.056). A reduction in umbilical cord–blood pH (relative risk, 3.9; P=.04) or the occurrence of perineal or vaginal laceration (relative risk, 6.4; P=.028) during vaginal delivery significantly increased the risk of vertical HCV transmission. In conclusion, high maternal viremia, infantile hypoxia, and intrapartum exposure to virus-contaminated maternal blood increased the risk of HCV transmission during vaginal deliveries. Consequently, cesarean section may reduce the risk of vertical HCV transmission in selected cases
ISSN:0022-1899
1537-6613
DOI:10.1086/367704