Maternal Hepatitis B Virus or Hepatitis C Virus Carrier Status and Long-Term Endocrine Morbidity of the Offspring—A Population-Based Cohort Study

Naim Abu Freha,Tzvi Najman Menachem,Eyal Sheiner,Tamar Wainstock

doi:10.3390/jcm9030796

Naim Abu Freha, Tzvi Najman Menachem + Show 2 more

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https://doi.org/10.3390/jcm9030796

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Abstract

This study aimed to investigate the long-term effect of maternal hepatitis B virus (HBV) or hepatitis C virus (HCV) carrier status on offspring endocrine morbidity. A population-based cohort study included all singleton deliveries between the years 1991–2014 at the Soroka University Medical Center, Beer-Sheva, Southern Israel. The mothers were subdivided into three groups, HBV carriers, HCV carriers and non-carriers. Data regarding the long-term endocrine morbidity of their offspring were compared between the groups. The study included 242,905 (99.7%) non-carrying mothers, 591 (0.2%) mothers who were carriers for HBV and 186 (0.1%) mothers who were carriers for HCV. The Kaplan–Meier’s survival curve demonstrated a significantly higher cumulative endocrine morbidity in children born to mothers with HCV (log-rank test, p = 0.002). Specifically, higher rates of hypoglycemia were noted among the offspring born to mothers who were carriers of HCV (1.1%; p = 0.001) compared with the offspring of mothers who were either carriers of HBV (0.2%) or non-carriers (0.1%). A Cox regression model controlled for maternal age, gestational age, maternal diabetes, hypertensive disorders of pregnancy, found maternal HCV carrier status to be independently associated with pediatric endocrine morbidity in the offspring (adjusted hazard ratio = 5.05, 95% CI: 1.625–15.695, p = 0.005). Maternal HCV carrier status is an independent risk factor for long-term endocrine morbidity.

Highlights

Hepatitis B virus (HBV) and hepatitis C (HCV) infection are relatively common chronic liver infections among young people, including women of childbearing age
The cohort included all singleton infants born between the years 1991 and 2014 who were discharged alive from the Soroka University Medical Center (SUMC) and who were born to HBV- or hepatitis C virus (HCV)-carrying mothers (HBsAg and/or anti-HCV seropositive) according to the diagnosis list during the pregnancy or delivery hospitalization
The most important finding of the present population-based study is that the maternal HCV carrier status is an independent risk factor for the long-term endocrine morbidity of the offspring

Summary

Introduction

Hepatitis B virus (HBV) and hepatitis C (HCV) infection are relatively common chronic liver infections among young people, including women of childbearing age. A previous study found a prevalence of 0.4% carrier status for hepatitis B or C among pregnant women [3]. The carrier status of chronic HBV or HCV was found to be an independent risk factor for adverse perinatal and maternal outcomes [3]. HCV, is known to be associated with variable extrahepatic manifestations such as endocrine dysfunction, an increased risk of thyroid disease, diabetes mellitus and hepatic steatosis [4,5,6,7,8,9,10]. Infection with HCV is frequently associated with high titers of anti-thyroid antibodies that further increase the patient’s risk for developing hypothyroidism [11,12]

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