Hillemanns P, Dannecker C, Kimmig R, Hasbargen U
Department of Obstetrics and Gynecology, Ludwig-Maximillians-University, Munich, Germany.
Acta Obstet Gynecol Scand. 2000 Jul;79(7):543-7.
Reports of obstetric complications of mothers infected with hepatitis C virus (HCV) are limited and the risk of mother-to-infant transmission varies widely. We assessed the course of pregnancy in HCV-infected women and the rate of vertical transmission.
Between October 1992 and December 1996, 3712 pregnant patients of the university hospital Grosshadern Munich, Germany, were screened for anti-HCV and analyzed for HCV-RNA by polymerase chain reaction. Clinical and biochemical parameters were monitored. Children born to HCV-positive women were followed up at 6, 12 and 18 month intervals and screened for anti-HCV and HCV-RNA.
Thirteen (42%) of 31 anti-HCV positive patients had a cesarean section which was twice the rate of that in the HCV-negative group (p=0.004). None of the cesarean deliveries was due to complications directly caused by HCV infection. Nine (29%) of 31 anti-HCV positive women had preterm delivery compared to 19% in the anti-HCV negative patients, the difference being statistically not significant. Fetal outcome parameters such as APGAR score, umbilical pH and birth weight of HCV infected pregnancies were not impaired. All 29 babies tested for anti-HCV were seropositive after birth. Between 12 and 18 months of age, 10% of the infants still were anti-HCV positive, whereas only one baby was HCV-RNA positive beyond 12 months yielding a vertical transmission rate of 5% among HCV-RNA positive mothers.
Anti-HCV positive pregnancies have an increased risk of cesarean delivery, probably due to the high-risk collective of anti-HCV positive mothers. The mother-to-child transmission rate is low and linked to maternal HCV-RNA positivity.
关于丙型肝炎病毒（HCV）感染母亲产科并发症的报道有限，母婴传播风险差异很大。我们评估了HCV感染女性的妊娠过程及垂直传播率。
1992年10月至1996年12月期间，对德国慕尼黑格罗斯哈登大学医院的3712名孕妇进行了抗HCV筛查，并通过聚合酶链反应分析HCV-RNA。监测临床和生化参数。HCV阳性女性所生儿童每隔6、12和18个月进行随访，并筛查抗HCV和HCV-RNA。
31名抗HCV阳性患者中有13名（42%）进行了剖宫产，这是HCV阴性组剖宫产率的两倍（p=0.004）。所有剖宫产均非由HCV感染直接导致的并发症引起。31名抗HCV阳性女性中有9名（29%）早产，抗HCV阴性患者中这一比例为19%，差异无统计学意义。HCV感染妊娠的胎儿结局参数，如阿氏评分、脐血pH值和出生体重均未受影响。所有29名接受抗HCV检测的婴儿出生后血清学均为阳性。在12至18个月龄时，10%的婴儿抗HCV仍为阳性，而12个月后只有1名婴儿HCV-RNA阳性，HCV-RNA阳性母亲的垂直传播率为5%。
抗HCV阳性妊娠剖宫产风险增加，可能是由于抗HCV阳性母亲这一高危群体所致。母婴传播率较低，且与母亲HCV-RNA阳性有关。
