The prevalence of hepatitis C virus (HCV) infection has increased significantly among pregnant women over the past two decades, according to findings published in Obstetrics and Gynecology.
Hepatitis C is a blood-borne infection that can be transmitted via shared needles and personal care items, through sex (especially sex between men) and from mother to child during pregnancy or delivery. HCV has become more common among women of child-bearing age in conjunction with the ongoing opioid epidemic.
Brittany Arditi, MD, of Columbia University in New York City, and colleagues used the National Inpatient Sample to analyze hepatitis C diagnosis during pregnancy. They assessed the average annual percent change for HCV diagnosis and associated clinical characteristics. The researchers also assessed links between hepatitis C and preterm delivery, cesarean delivery and severe maternal morbidity.
“The opioid epidemic and resultant increasing rates of intravenous drug use are thought to account for a large proportion of the rising incidence of HCV infection,” the study authors wrote. “However, 50% of individuals with HCV infection report no history of intravenous drug use. As such, there is a knowledge gap with regards to other risk factors, demographic and clinical characteristics, and comorbidities associated with HCV infection among pregnant patients.”
The analysis included 76.7 million delivery hospitalizations, of which 182,904 (0.24%) involved women diagnosed with HCV. From 2000 to 2019, the prevalence of HCV diagnosis during pregnancy rose nearly 10-fold, from 0.05% to 0.49%, representing an average annual percent change of 12.5%.
During this period, clinical characteristics linked to HCV diagnosis also became more common. The prevalence of opioid use disorder per 10,000 hospital births increased from 10 to 71, non-opioid substance use disorder rose from 71 to 217, mental health conditions increased from 219 to 1,117 and tobacco use rose from 61 to 842.
Moreover, the delivery rate among women with multiple clinical characteristics associated with HCV rose from 26 to 377 cases per 10,000 birth hospitalizations, for an average annual percent change of 13.4%. Hepatitis C was linked to higher risk for preterm delivery, cesarean delivery and severe maternal morbidity.
“Diagnosis of HCV infection is increasingly common in the obstetric population, which may reflect an increase in screening or a true increase in prevalence,” wrote the researchers. “Identifying and treating women at high risk for infection before pregnancy may be important in optimizing care.”