Prevalence of Hepatitis C Among Pregnant Women Increased 16-Fold From 1998-2018

In a cross-sectional study, researchers found that from 1998 through 2018, the number of hepatitis C infections (HCV) among pregnant women substantially increased, highlighting the need for universal HCV screening during pregnancy.

In their study, Chen and colleagues sought to determine the prevalence of HCV during pregnancy as there is little data that represents this patient population. Additionally, the authors noted, adults can potentially acquire HCV through intravenous drug use, and more than one-third of newly reported HCV cases occur in women aged 20 to 39 years.

The authors analyzed data of more than 70 million births or spontaneous abortions during the study period using the National Inpatient Sample, which is the largest publicly available all-payer inpatient care database in the United States. Of the total population, 137,259 participants had HCV (0.20%; 95% CI, 0.19%-0.21%). When compared with HCV-negative participants, the demographics of the HCV-positive participants were more often White (77.4%; 95% CI, 76.1%-78.6%), low-income (40.0%; 95% CI, 38.6%-41.5%), and likely to have histories of tobacco (41.7%; 95% CI, 40.6%-42.9%), alcohol (1.8%; 95% CI, 1.6%-2.0%), and opioid use (28.9%; 95% CI, 27.3%-30.6%).

During the study period, the prevalence of HCV-positive pregnancies increased 16-fold, with 5.3 cases per 1000 pregnancies in 2018. Further, the researchers found that there were higher odds of participants who tested positive for HCV to experience cesarean delivery, preterm labor, poor fetal growth, or fetal distress. No differences were observed in gestational diabetes, preeclampsia, eclampsia, or stillbirths.

This study had limitations, most notably that some pregnant women could have been unscreened or miscoded at hospital discharge, which could potentially lead to misclassification bias within the study.

“HCV infection is associated with a heightened risk of adverse maternal and perinatal outcomes. Overall, our data support the recommendations for universal HCV screening with each pregnancy proposed by the Centers for Disease Control and Prevention and American College of Obstetricians and Gynecologists,” the researchers concluded. “Perinatal care and delivery may be the initial health care exposure for many women. These touchpoints represent an opportunity for health care professionals to identify HCV infection and link women and their children to appropriate specialist care.”

Reference:

Chen PH, Johnson L, Limketkai BN, et al. Trends in the Prevalence of Hepatitis C Infection During Pregnancy and Maternal-Infant Outcomes in the US, 1998 to 2018. Jama Netw Open. Published online July 21, 2023. doi:10.1001/jamanetworkopen.2023.24770