The rates of hepatitis C virus (HCV) among pregnant women in states that report proper data nearly doubled between 2009 and 2014, MedPage Today report. The opioid epidemic is likely driving up infection rates, and Appalachia is seeing particularly steep increases.

Publishing their findings in the Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention (CDC) researchers analyzed U.S. birth certificate data from 2009 from the National Vital Statistics System. For a closer look at one hard-hit state’s HCV infection rates, researchers analyzed Tennessee birth certificates from the Department of Health Vital Records.

Among states that reported mothers’ HCV infection status on birth certificates, overall infection rates rose 89 percent during the study period, from 1.8 per 1,000 live births (0.18 percent) in 2009 to 3.4 per 1,000 (0.34 percent) in 2014.

After adjusting the Tennessee data for various factors, the researchers found that having hepatitis B virus (HBV) increased the odds that a pregnant woman would have HCV 16.6-fold, while smoking during pregnancy increased the odds 4.49-fold and living in a rural county compared with living in an urban county increased the odds about threefold.

In Tennessee, the highest rates of HCV infection among pregnant women were in the 52 Appalachian counties.

Compared with women who did not have the virus, women with HCV at the time of giving birth  were more likely to have only a high school education, be unmarried, have had late or no prenatal care and to smoke, compared with those who were HCV negative upon giving birth.

The 2014 HCV infection rates among pregnant women varied widely between states, from a low of 0.7 per 1,000 live births in Hawaii to 22.6 per 1,000 live births in West Virginia. Between 2009 and 2014, the infection rate in Tennessee rose from 3.8 per 1,000 live births to 10 per 1,000 live births.

The study authors note that the rise in HCV infection among expectant mothers coincides with the expanding, interconnected epidemics of heroin and prescription drug addiction.

To read the MedPage Today article, click here.

To read the CDC report, click here.

To read a press release about the study, click here.