Objectives
Opiate addiction in pregnancy has increased five-fold in the last decade and intravenous opioid use is associated with the acquisition of blood borne pathogens, such as hepatitis C virus (HCV). In pregnancy, perinatal HCV transmission occurs in 5.8% of HIV uninfected women. Our objectives were to a) determine the prevalence of HCV infection at a large tertiary care maternity hospital over the last decade, b) describe the characteristics of pregnant women with HCV and c) compare obstetric and neonatal outcomes between HCV-infected and non-HCV infected pregnant women.
Methods
A retrospective cohort of 88,317 pregnant women between January 1, 2006 and December 31, 2014 was identified. HCV infection was defined by an HCV positive antibody screen and extracted from medical records using ICD-9 diagnostic codes. HCV prevalence by year was evaluated using chi-square for linear trend. Demographic characteristics, insurance provider, birth weight, gestational age at delivery, Apgar scores, neonatal seizures and neonatal abstinence syndrome were compared in women with HCV to those without HCV using Fishers exact test.
Methods
A retrospective cohort of 88,317 pregnant women between January 1, 2006 and December 31, 2014 was identified. HCV infection was defined by an HCV positive antibody screen and extracted from medical records using ICD-9 diagnostic codes. HCV prevalence by year was evaluated using chi-square for linear trend. Demographic characteristics, insurance provider, birth weight, gestational age at delivery, Apgar scores, neonatal seizures and neonatal abstinence syndrome were compared in women with HCV to those without HCV using Fishers exact test.
Results
Over a 9 year study period, 1049 (1.2%) pregnant women were HCV infected. In bivariate analyses, HCV infected women were more likely younger (<30 years of age) (66% vs. 53%, p <0.001), Caucasian (93% vs. 72%, p<0.001) and have medical assistance (77% vs. 29%, p<0.001) than HCV uninfected women (Table). Infants born to HCV infected women were more likely to be preterm (< 37 weeks gestation) (22% vs. 11%, p<0.001) and low birth weight (< 2,500 grams) (23% vs. 8%, p<0.001) (Table). Over time, rates of HCV infection increased from 1031 per 100,000 women in 2006 to 1632 cases per 100,000 women in 2014 (p<0.01).
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