HCV and Pregnancy: Prevalence, Risk Factors, and Pregnancy Outcome in North Indian Population: A Case–Control Study

Abstract

Objectives The study was carried out to investigate the prevalence, risk factors, and Pregnancy outcome in anti-HCV-positives pregnant women admitted for delivery in the Department of Obstetrics & Gynecology of Guru Gobind Singh Medical College and Hospital, Faridkot between January 2010 and January 2013. Setting Department of obstetrics and Gynaecology of GGS Medical College and Hospital, Faridkot. Material and Methods A case-control study design was selected for the study. A total of 1412 pregnant women presenting in the labor room of our hospital between January 2010 and January 2013 were subjected to anti-HCV testing by third generation ELISA. Age, parity, and gestational age-matched controls were taken from the women delivering during the same time frame who tested negative for hepatitis C. All the subjects and controls were nonreactive for HIV and HBsAg as well. Risk factors and pregnancy outcome were compared with the control group. Approval was taken from ethic committee of the institute. The women who consented to participate in the study were evaluated on the basis of a questionnaire for the presence of 123 risk factors of hepatitis C and pregnancy outcome. Women with the known previous liver disease were excluded from the study. Data were analyzed using SPSS for Windows version 16.0. p \ 0.05 was considered significant. Results Forty patients tested positive for anti-HCV antibodies among 1,412 patients subjected to anti-HCV testing during study period. 40 patients were taken as controls, who were negative for anti-HCV antibodies. Prevalence of HCV during pregnancy was 2.8 % in our study. Among the risk factors studied, previous surgery and blood transfusion were the statistically significant risk factors. There was history of previous major surgery in 16 cases versus 4 controls and was statistically significant (p value 0.002) at p \ 0.05. History of blood transfusion was present in 4 versus 2 among cases and controls, respectively, and statistically significant (p value 0.004) at p \ 0.05. Sexual transmission was not the risk factor as none of the spouse of the pregnant women was positive for HCV antibodies. Neonatal outcome was similar in both groups. Pregnancy complications i.e., Pregnancy-induced hypertension and antepartum hemorrhage were significantly higher in study group compared to control group. Conclusion Incidence of hepatitis C virus infection in pregnancy is 2.8 %. Surgical procedures, blood transfusion, are the major risk factors for transmission. There are no identifiable risk factors in 35 % of cases. Pregnancy complications like Pregnancy-induced hypertension and antepartum hemorrhage are more common in HCV-positive mothers. Neonatal outcome is not affected. Universal screening of all pregnant women should be done for HCV as many patients may not have any risk factor.

Prevalence of hepatitis C among pregnant females attending antenatal clinic at a tertiary care hospital in Lucknow, Uttar Pradesh, India

“…In contrast to this finding, a study from Faridkot, Punjab reported higher seropositivity among pregnant women belonging to rural areas (72.5%, 29/40) as compared to those from urban areas (27.5%, 11/40). 29 In the present study it was found that majority of pregnant females belonged to lower socio-economic class (68.4%, 376/550), followed by those belonging to middle class (30.0%, 165/550) and least from upper class (1.6%, 9/550). All the 3 reactive females belonged to lower class.…”

“…28 Similarly, studies from New Delhi and Punjab reported high prevalence of hepatitis C among pregnant women to be 1.03% and 2.8% respectively. 20,29 This 28 Another study from Faridkot, Punjab also reported higher seropositivity among pregnant women belonging to age group 21-25 years (45%, 18/40) and 26-30 years (30%, 12/40). 29 These findings were comparable to the present study.…”

Burden of hepatitis C virus infection in India: A systematic review and meta‐analysis

“…Anti-HCV prevalence data among pregnant women were available from 15 reports from seven states. [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] One study from Chhattisgarh reported a very high seroprevalence rate not only for anti-HCV (7/100; 7.0% [2.86-13.89%]) but also for HBsAg (9/100; 9.0%) and anti-HIV antibodies (12/100; 12%) 14 ; because these rates were quite unusual, this study was excluded from analysis.…”

Tackling the Hepatitis C Disease Burden in Punjab, India

“…A study carried out in Faridkot by Goyal et al 32 screened 1412 pregnant women and found HCV seropositivity in 2.8%. The risk factors to acquire HCV infection identified from this study were a history of previous surgery and blood transfusion.…”