Elrazek Abd, Saab Samy, Foad Mahmoud, Elgohary Elsayed A, Sallam Mohammad M, Nawara Abdallah, Ismael Ali, Morsi Samar S, Salah Altaher, Alboraie Mohamed, Bhagavathula Akshaya Srikanth, Zayed Marwa, Elmasry Hossam, Salem Tamer Z
Department of Hepatology and Gastroenterology, Aswan School of Medicine, Aswan University, Egypt.
Department of Medicine and Surgery, David Geffen School of Medicine, University of California Los Angeles (UCLA), USA.
J Transl Int Med. 2017 Mar 31;5(1):27-33. doi: 10.1515/jtim-2017-0001. eCollection 2017 Mar.
Over the past few decades, cesarean section (CS) rates are steadily increasing in most of the middle- and high-income countries. However, most of the pregnant women (particularly undergoing CS) are not screened for hepatitis C virus (HCV); hence, neonates born to HCV-positive mother could be a source of future HCV infection. In this study, the role of the CS and other surgical interventions in HCV transmission in Egypt, the highest endemic country of HCV-4, was investigated.
From January to June 2016, a prospective cohort study was conducted among 3,836 pregnant women in both urban and rural areas across Egypt for HCV screening in both mothers and neonates born to HCV-positive mother. All pregnant women were screened during third trimester or just before delivery, neonates born to HCV-positive mothers were evaluated within 24-h postdelivery to record vertical transmission cases. Data mining (DM)-driven computational analysis was used to quantify the findings.
Among 3,836 randomized pregnant women, HCV genotype 4 was identified in 80 women (2.08%). Out of 80 HCV-infected women, 18 have experienced surgical intervention (22.5%) and 62 CS (77.5%). HCV vertical transmission was identified in 10 neonates, 10/80 (12.5%).
Screening women who had experienced surgical intervention or CS during child bearing period and before pregnancy might prevent HCV mother-to-child transmission (MTCT). CS should be ethically justified to decrease global HCV transmission.
在过去几十年中，大多数中高收入国家的剖宫产率在稳步上升。然而，大多数孕妇（尤其是接受剖宫产的孕妇）未接受丙型肝炎病毒（HCV）筛查；因此，HCV阳性母亲所生的新生儿可能成为未来HCV感染的来源。在本研究中，调查了剖宫产及其他外科手术干预在埃及（HCV-4感染率最高的流行国家）HCV传播中的作用。
2016年1月至6月，对埃及城乡地区的3836名孕妇进行了一项前瞻性队列研究，以筛查母亲及HCV阳性母亲所生新生儿的HCV感染情况。所有孕妇在妊娠晚期或临产前进行筛查，HCV阳性母亲所生的新生儿在出生后24小时内进行评估，以记录垂直传播病例。采用数据挖掘（DM）驱动的计算分析对研究结果进行量化。
在3836名随机选取的孕妇中，80名妇女（2.08%）被鉴定为HCV基因型4。在80名HCV感染妇女中，18名经历了外科手术干预（22.5%），62名接受了剖宫产（77.5%）。10名新生儿被鉴定为HCV垂直传播，10/80（12.5%）。
在育龄期及孕前对经历过外科手术干预或剖宫产的妇女进行筛查，可能会预防HCV母婴传播（MTCT）。剖宫产应从伦理角度进行论证，以减少全球HCV传播。
