National trends of hepatitis B and C during pregnancy across sociodemographic, behavioral, and clinical factors, United States, 1998–2011

Abstract

Currently, data examining nationally representative prevalence and trends of HBV or HCV among specific subgroups of pregnant women in the US are unavailable. We conducted a cross-sectional analysis of hospitalizations for liveborn singleton deliveries from 1998 to 2011 using data from the Nationwide Inpatient Sample. After identifying deliveries with HBV, HCV, and HIV infection during pregnancy, survey logistic regression was used to identify risk factors. Temporal trends were analyzed using joinpoint regression. The rates of HBV and HCV were 85.8 and 118.6 per 100,000 deliveries, respectively; however, there was substantial variation across maternal and hospital factors. The HBV rate increased from 57.8 in 1998 to 105.0 in 2011, resulting in an annual increase of 5.5% (95% CI: 3.8-7.3). The HCV rate increased fivefold, from 42.0 in 1998 to over 210 in 2011. These trends were observed for nearly every population subgroup. However, we did observe differences in the degree to which hepatitis during pregnancy was becoming more prevalent. The increasing national trend in the prevalence of hepatitis among pregnant women was particularly concerning among already high-risk groups. This underscores the need for coordinated approaches-encompassing culturally-appropriate health education/risk-reduction programs, and increased vaccination and screening efforts-championed by health providers. J. Med. Virol. 89:1025-1032, 2017. © 2016 Wiley Periodicals, Inc.

Hepatitis C Cascade of Care Among Pregnant Women on Opioid Agonist Pharmacotherapy Attending a Comprehensive Prenatal Program

“…Two studies have estimated that between 10–17 of 100,000 pregnant women are chronically infected with HCV (Ellington, Flowers, Legardy-Williams, Jamieson, & Kourtis, 2015; Salihu et al, 2012). However, a recent retrospective study of inpatient pregnancies in the U.S. between 1998 and 2011, showed that HCV rates per 100,000 deliveries increased by over 5-fold, from 42 to 210 in those years, respectively (Salemi et al, 2016). Given this significant increase, it’s evident that HCV infection is rising in pregnant women.…”

Hepatitis C Virus in Pregnancy: A Systematic Review of the Literature

“…This relationship is most clearly defined in regards to coinfection with HIV and HCV. Mothers 19 Four of the included studies identified HIV infection as a risk factor for HCV. 17,19,22,23 An additional two studies found an association between history of any sexually transmitted infection and HCV.…”

HCV in Women and Pregnancy

“…(17) In the United States, the prevalence of infants born to HCV-infected mothers ranges from 0.5% in Ohio (18) to 2.3% in West Virginia, (19) with a 68% increase in infants born to HCV-infected women nationally, disproportionately higher than that in HBV or HIV. (20) Overall, there has been a 39% increase in HCV-positive pregnant women and 13% increase in HCV-positive children reported between 2011 and 2016. This may in part be due to increased testing, but it highlights the continued role of perinatal HCV transmission.…”