OBJECTIVE To evaluate the risks of adverse maternal and neonatal outcomes associated with pregnancies complicated by hepatitis C virus (HCV) infection. METHODS This is a secondary analysis of a multicenter prospective cohort study of HCV infection in pregnancy. Participants were screened for HCV infection with serum antibody tests, and each participant with a positive HCV result (case group) was matched with up to two individuals with negative HCV results (control group) prospectively by gestational age (±2 weeks) at enrollment. Maternal outcomes included gestational diabetes, abruption, preeclampsia or gestational hypertension, cholestasis, and preterm delivery. Neonatal outcomes included hyperbilirubinemia, admission to neonatal intensive care (NICU); small-for-gestational-age (SGA) birth weight; and neonatal infection , defined as sepsis or pneumonia. Models were adjusted for maternal age, body mass index, injection drug use, and maternal medical comorbidities. RESULTS The 249 individuals in the case group were prospectively matched to 486 individuals in the control group who met eligibility criteria. There were significant differences in demographic characteristics between the groups, including race, socioeconomic markers, education, insurance status, and drug and tobacco use. The frequencies of maternal outcomes of gestational diabetes, preeclampsia, and abruption were similar between the case and control groups. Preterm birth was similar between groups, but neonates born to individuals in the case group were more likely to be admitted to the NICU (45.1% vs 19.0%, adjusted odds ratio [aOR] 2.6, 95% CI, 1.8-3.8) and to have SGA birth weights below the 5th percentile (10.6% vs 3.1%, aOR 2.9, 95% CI, 1.4-6.0). There were no increased odds of hyperbilirubinemia or neonatal infection. CONCLUSION Despite no increased odds of preterm birth or other adverse maternal outcomes in adjusted analyses, maternal HCV infection was associated with twofold increased odds of NICU admission and nearly threefold increased odds of SGA birth weight below the 5th percentile.

中文翻译：

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丙型肝炎病毒感染患者的妊娠结局。


目的 评估与妊娠并发丙型肝炎病毒 （HCV） 感染相关的不良孕产妇和新生儿结局的风险。方法 这是对妊娠期 HCV 感染的多中心前瞻性队列研究的二次分析。参与者通过血清抗体检测筛查 HCV 感染，每个 HCV 结果呈阳性的参与者（病例组）在入组时按胎龄（±2 周）前瞻性地与最多两名 HCV 结果呈阴性的个体（对照组）进行匹配。孕产妇结局包括妊娠糖尿病、胎盘早剥、子痫前期或妊娠高血压、胆汁淤积和早产。新生儿结局包括高胆红素血症、新生儿重症监护室 （NICU） 收治;小于胎龄儿 （SGA） 出生体重;和新生儿感染，定义为败血症或肺炎。根据孕产妇年龄、体重指数、注射药物使用和孕产妇医学合并症调整模型。结果 病例组的 249 例个体与对照组中符合资格标准的 486 例个体进行了前瞻性匹配。两组之间的人口统计学特征存在显著差异，包括种族、社会经济标志物、教育程度、保险状况以及药物和烟草使用。病例组和对照组之间孕产妇妊娠糖尿病、子痫前期和胎盘早剥结局的频率相似。两组早产相似，但病例组中个体所生的新生儿更有可能入住 NICU （45.1% vs 19.0%，校正比值比 [aOR] 2.6,95% CI，1.8-3.8）和 SGA 出生体重低于第 5 个百分位数 （10.6% vs 3.1%，aOR 2.9,95% CI，1.4-6.0）。 高胆红素血症或新生儿感染的几率没有增加。结论 尽管在调整后的分析中早产或其他不良孕产妇结局的几率没有增加，但母体 HCV 感染与 NICU 入住几率增加两倍和 SGA 出生体重低于第 5 个百分位数的几率增加近三倍相关。