McMenamin Moya B, Jackson Abigail D, Lambert John, Hall William, Butler Karina, Coulter-Smith Sam, McAuliffe Fionnuala M
Department of Obstetrics and Gynaecology, National Maternity Hospital, University College Dublin School of Medicine and Medical Science, Dublin, Ireland.
Am J Obstet Gynecol. 2008 Sep;199(3):315.e1-5. doi: 10.1016/j.ajog.2008.05.021.
The objective of the study was to determine vertical transmission rates of hepatitis C in 2 tertiary level maternity units.
This was a retrospective review of all hepatitis C-positive mothers and their pregnancy outcomes.
Of 74,629 deliveries, 559 liveborn infants were born to 545 hepatitis C mothers; the rate of antenatal hepatitis C infection was 0.7%. In the neonatal period, 423 infants tested negative for hepatitis C ribonucleic acid (RNA) (75.7%), 18 were positive (3.2%), and 118 infants were not tested or were lost to follow-up (21.1%). The overall vertical transmission rate is 18 of 441 (4.1%, 95% confidence interval 2.3% to 5.9%). The vertical transmission rate for infants following vaginal delivery or emergency cesarean in labor was no different when compared with those delivered by planned cesarean (4.2% vs 3.0%, P = NS). Among women in whom hepatitis C RNA was detected antenatally, this finding remained (7.2% vs 5.3%, P = NS). No case of vertical transmission was noted among hepatitis C RNA-negative mothers.
This study reports a vertical transmission rate for hepatitis C of 4.1%. These results do not support a recommendation of planned cesarean to reduce vertical transmission of hepatitis C infection.
本研究的目的是确定两家三级产科单位丙型肝炎的垂直传播率。
这是一项对所有丙型肝炎阳性母亲及其妊娠结局的回顾性研究。
在74,629例分娩中，545名丙型肝炎母亲生下了559名活产婴儿；产前丙型肝炎感染率为0.7%。在新生儿期，423名婴儿丙型肝炎核糖核酸（RNA）检测呈阴性（75.7%），18名呈阳性（3.2%），118名婴儿未检测或失访（21.1%）。总体垂直传播率为441例中的18例（4.1%，95%置信区间2.3%至5.9%）。与计划剖宫产分娩的婴儿相比，经阴道分娩或分娩时急诊剖宫产的婴儿垂直传播率没有差异（4.2%对3.0%，P = 无显著性差异）。在产前检测到丙型肝炎RNA的女性中，这一结果仍然成立（7.2%对5.3%，P = 无显著性差异）。丙型肝炎RNA阴性的母亲中未发现垂直传播病例。
本研究报告丙型肝炎的垂直传播率为4.1%。这些结果不支持推荐计划剖宫产以降低丙型肝炎感染的垂直传播。
