Feto-Maternal Outcomes of Hepatitis E Virus Infection in Pregnancy of Bangladeshi women.

Abstract

Hepatitis E virus (HEV) infection is responsible for more than half of acute viral hepatitis (AHV) with high feto-maternal complications. Bangladesh has high prevalence of HEV infection among pregnant women. This study was undertaken to observe fetal -maternal outcome of HEV infection in Bangladeshi pregnant women . For this purpose a total of 56 pregnant women with AVH were enrolled from two tertiary care hospitals of Dhaka, Bangladesh. Blood samples were collected and tested for HEV Ig-M, HBsAg and Anti HCV.Thirty one pregnant women were tested positive for HEV Ig-M, acted as case and rest 25 women had viral hepatitis other than HEV, acted as control group (non-HEV). Among the HEV infected pregnant women, 38.7% of the patients (12/31) were aged between 21-25 years with mean age of 23.7 + SD 4.5 years. Twelve (39%) AVH-E patient died due to fulminant hepatic failure (FHF), hepatic encephalopathy (HFE) and multiorgan dysfunction. Maternal mortality due to HEV was greater [ (RR), 9.6; 95% CI, 1.3 to 69.5] in HEV-infected women than in non-HEV infected women and it was higher in 2nd trimester (55.5%) then the 1st and 3rd trimester of pregnancy. Babies born to pregnant women with acute Hepatitis due to HEV (AHV-E) were more likely to have intrauterine death (RR 18.68; p = 0.03) and preterm delivery (RR 7.25; p = 0.05) than the non-HEV infected pregnant women. Only 23% (7/31) babies reached up to term maturity. In conclusion, his study reveals that comparing with non-HEV infection, pregnant women with AHV-E infection causes worse feto-maternal outcomes especially in the second trimester of pregnancy which needs special attention of healthcare providers to reduce bad obstetric outcome in HEV endemic countries.

Seroprevalence and risk factors of Hepatitis E virus infection among pregnant women attending antenatal care in health facilities of Tigray, Northern Ethiopia

“…Since we found very few pregnant women infected with HEV using anti HEV IgM, we were unable to compare risk factor analysis and provide reasons for this findings, and we only performed risk factor analysis based on IgG results. However, IgM based prevalence reports from the current study is lower than studies done in Pakistan, Ghana, and Benin, but higher than studies done in Cameron, Bangladesh, and Spain …”