Berkley Eliza M F, Leslie Kimberly K, Arora Sanjeev, Qualls Clifford, Dunkelberg Jeffrey C
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.
Obstet Gynecol. 2008 Aug;112(2 Pt 1):304-10. doi: 10.1097/AOG.0b013e318180a4f3.
To estimate outcomes, to determine whether appropriate follow-up was performed for pregnant patients with hepatitis C virus (HCV), and to show that maternal and neonatal complications would be higher in the HCV-positive group.
We compared pregnant women from a drug dependence and treatment program who were HCV antibody-positive with those who were HCV antibody-negative using the University of New Mexico Perinatal Database. Maternal and neonatal outcomes were evaluated, including cholestasis of pregnancy, preterm birth, low birth weight, neonatal intensive care unit admissions, and neonatal methadone withdrawal. Variables were compared using Student t, Fisher exact, and chi(2) tests.
Among 351 pregnancies between January 2000 and 2006, 159 (53%) were HCV antibody reactive, 141 (47%) tested nonreactive, and 51 (15%) were not screened. Hepatitis C reactivity was more common among Hispanics. Cholestasis of pregnancy was increased in HCV antibody reactive (Ab+) pregnancies (10 of 159, 6.3% compared with 0 of 141, P=.002). Among women taking methadone, there was a significantly higher incidence of neonatal withdrawal (P=.001). This was significant in mothers on low (0-30 mg) and moderate (31-90 mg) methadone doses. Despite the high cure rate with intensive therapy, only 5.7% of HCV Ab+ mothers and 1.9% of their neonates received gastroenterology referrals.
In pregnant women involved in this drug treatment program, HCV reactivity was associated with Hispanic ethnicity, cholestasis of pregnancy, and increased neonatal methadone withdrawal regardless of maternal methadone dose. Gastroenterology consultation was inadequate.
评估妊娠结局，确定丙型肝炎病毒（HCV）感染孕妇是否接受了适当的随访，并证明HCV阳性组的母婴并发症会更高。
我们使用新墨西哥大学围产期数据库，将来自药物依赖与治疗项目的HCV抗体阳性孕妇与HCV抗体阴性孕妇进行比较。评估母婴结局，包括妊娠胆汁淤积症、早产、低出生体重、新生儿重症监护病房入院率以及新生儿美沙酮戒断情况。使用学生t检验、Fisher精确检验和卡方检验对变量进行比较。
在2000年1月至2006年期间的351例妊娠中，159例（53%）HCV抗体反应阳性，141例（47%）检测为非反应性，51例（15%）未进行筛查。HCV反应性在西班牙裔中更为常见。HCV抗体反应阳性（Ab+）妊娠中妊娠胆汁淤积症增加（159例中有10例，6.3%，而141例中为0例，P = 0.002）。在服用美沙酮的女性中，新生儿戒断发生率显著更高（P = 0.001）。这在服用低剂量（0 - 30毫克）和中等剂量（31 - 90毫克）美沙酮的母亲中具有显著性。尽管强化治疗治愈率高，但只有5.7%的HCV Ab+母亲及其1.9%的新生儿接受了胃肠病学转诊。
在参与该药物治疗项目的孕妇中，HCV反应性与西班牙裔种族、妊娠胆汁淤积症以及新生儿美沙酮戒断增加有关，与母亲美沙酮剂量无关。胃肠病学咨询不足。
