Hepatitis C in Pregnancy Increases NICU Admissions

TOPLINE: 

Maternal hepatitis C virus (HCV) infection is associated with a twofold increase in NICU admissions and nearly threefold increase in small-for-gestational-age births below the 5th percentile.

METHODOLOGY:

• Researchers conducted a secondary analysis of a multicenter prospective cohort study involving 249 individuals with HCV infection and 486 controls.
• Participants were screened for HCV infection with serum antibody tests and matched by gestational age at enrollment.
• Maternal outcomes included gestational diabetes, preeclampsia, abruption, cholestasis, and preterm delivery.
• Neonatal outcomes included hyperbilirubinemia, NICU admission, small-for-gestational-age (SGA) birth weight, and neonatal infection.
• Data were collected from medical records by trained and centrally certified research staff at each site.

TAKEAWAY:

• According to the authors, maternal HCV infection was associated with a twofold increased odds of NICU admission (adjusted odds ratio [aOR], 2.6; 95% CI, 1.8-3.8).
• The researchers found that neonates born to individuals with HCV infection had nearly threefold increased odds of SGA birth weight below the 5th percentile (aOR, 2.9; 95% CI, 1.4-6).
• No significant association was found between HCV infection and adverse maternal outcomes such as gestational diabetes, preeclampsia, or abruption.
• The study highlighted that 57.7% of neonates in the case group had a diagnosis of neonatal abstinence syndrome compared to 10% in the control group.

IN PRACTICE:

“These data provide important information for clinicians counseling patients with HCV infection both before and during pregnancy. The higher rate of SGA births may warrant increased fetal growth surveillance in the third trimester for individuals with maternal HCV infection,” wrote the authors of the study.

SOURCE:

The study was led by Brenna L. Hughes, MD, MSc, Duke School of Medicine, Durham, North Carolina. It was published online in Obstetrics & Gynecology.

LIMITATIONS: 

The study’s limitations include the inability to perform multivariable modeling for outcomes with low frequencies and the potential underreporting of sensitive confounding variables. Additionally, the study’s observational nature means the results should be interpreted as exploratory.

DISCLOSURES:

Brenna Hughes disclosed an ongoing financial relationship with UpToDate. Rebecca Clifton reported funding from the University of Arkansas for Medical Sciences and the NIH. Anna Bartholomew received money from NICHD and George Washington University. Alan Tita reported money from Pfizer. Torri D. Metz received UpToDate royalties and money from Pfizer for clinical trials. Geeta Swamy reported funding from GlaxoSmithKline, Pfizer, Medscape, UpToDate, Moderna, and Sanofi. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.