Research Center for Gastroenterology and Liver Disease, University of Medical Sciences, Tehran, Iran.
Arch Gynecol Obstet. 2011 Feb;283(2):255-60. doi: 10.1007/s00404-010-1588-9. Epub 2010 Jul 21.
Hepatitis C virus (HCV) vertical transmission is considered the main route of HCV infection in children. Some authors have stated that cesarean section (C/S) can reduce perinatal HCV transmission. However, the study findings are heterogeneous and high-quality studies are lacking.
To evaluate the effect of mode of delivery on the risk of perinatal mother-to-infant transmission of HCV.
Only the peer-reviewed published studies that compared perinatal transmission rate of HCV in elective or emergency cesarean section with vaginal delivery in HCV-RNA+/HIV- mothers were included. We applied the random effect model of DerSimonian and Laird method with heterogeneity and sensitivity analyses.
We identified 8 studies that involved 641 unique mother-infant pairs which fulfilled our inclusion criteria. Aggregation of study results did not show a significant decrease in HCV vertical transmission among study (mothers who underwent C/S) versus control (mothers who gave birth vaginally) patients [pooled odds ratio, 1.1 (95% CI 0.45-2.67)]. The P value was 0.35 for our test of heterogeneity.
Our meta-analysis suggests that C/S does not decrease perinatal HCV transmission from HCV-RNA+/HIV- mothers to infants.
丙型肝炎病毒（HCV）垂直传播被认为是儿童 HCV 感染的主要途径。一些作者指出，剖宫产（C/S）可以降低围产期 HCV 的传播。然而，研究结果存在异质性，且缺乏高质量的研究。
评估分娩方式对 HCV 母婴围产期传播风险的影响。
仅纳入了比较 HCV-RNA+/HIV- 母亲的择期或紧急剖宫产与阴道分娩的围产期 HCV 传播率的同行评审已发表研究。我们应用了具有异质性和敏感性分析的 DerSimonian 和 Laird 方法的随机效应模型。
我们确定了 8 项研究，其中包括 641 对符合我们纳入标准的母婴对。汇总研究结果显示，C/S 组与对照组（阴道分娩的母亲）之间 HCV 垂直传播没有显著降低[合并优势比，1.1（95%可信区间 0.45-2.67)]。我们对异质性的检验 P 值为 0.35。
我们的荟萃分析表明，C/S 不能降低 HCV-RNA+/HIV- 母亲向婴儿传播的围产期 HCV。
