1154 A comparison of maternal and neonatal outcomes in hepatitis C negative and positive pregnancies

Abstract

We sought to examine differences in maternal and neonatal outcomes between hepatitis C (HCV) positive and HCV negative pregnant persons in a large cohort of births. We conducted a retrospective cohort study of patients with singleton, non-anomalous births in California from 2007 to 2011. We included only those with gestational ages between 27 and 42 weeks. We evaluated maternal outcomes using occurrence of gestational hypertension, gestational diabetes, preterm delivery, mild to severe preeclampsia, eclampsia, severe maternal morbidity, premature rupture of membranes and induction of labor. We evaluated neonatal outcomes using neonatal death (within six weeks of birth), infant death (within one year of birth), NICU admissions over twenty-four hours, birth injuries and hypoxic ischemia encephalopathy. Analysis was performed with chi-square tests using a significance cutoff of 0.05 and logistic multivariate regressions controlling for ethnicity, age, parity, basal metabolic index, smoking status, insurance type and education level. In a California cohort of 2,375,487 births, 3,276 (0.14%) pregnant persons were HCV positive. Gestational diabetes (aOR 1.38 95% CI 1.21-1.56), preterm delivery (aOR 1.53 95% CI 1.38-1.70), severe maternal morbidity (aOR 2.01 95% CI 1.61-2.70), rupture of membranes before 37 weeks (aOR 1.41 95% CI 1.22-1.63) and induction of labor (aOR 1.12 95% CI 1.02-1.22) were significantly statistically different for HCV positive patients (Table 1). Infants born to HCV positive persons were found to have statistically significant numbers of infant deaths with an adjusted odds ratio (aOR) of 2.11 and 95% confidence interval (CI) 1.21-3.65 (Table 2). NICU admissions greater than twenty-four hours were also significantly higher in infants of HCV positive patients (aOR 2.41, 95% CI 2.20-2.64). In this analysis, the presence of HCV in pregnancy showed significantly different maternal outcomes compared to those without HCV infections and infants born to women with HCV infections showed worse outcomes when compared to infants born to HCV negative mothers.View Large Image Figure ViewerDownload Hi-res image Download (PPT)