Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States of America.
Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, United States of America.
PLoS One. 2023 Oct 18;18(10):e0291994. doi: 10.1371/journal.pone.0291994. eCollection 2023.
Hepatitis Virus C (HCV) infection rates have trended upwards among pregnant people in the USA since 2009. Existing evidence about HCV infections and maternal outcomes is limited; therefore, we used birth certificate data to investigate the association between HCV infection and maternal health outcomes.
We used the 2017 US birth certificate dataset (a cross-section of 1.4 million birth records) to assess the association between prevalent HCV infection and gestational diabetes, gestational hypertension, and eclampsia. Potential confounding variables included prenatal care, age, education, smoking, presence of sexually transmitted infections (STIs), body mass index (BMI), and weight gain during pregnancy. We restricted our analysis to only women with a first singleton pregnancy. Odds ratios were estimated by logistic regression models and separate models were tested for white and Black women.
Only 0.31% of the women in our sample were infected with HCV (n = 4412). In an unadjusted model, we observed a modest significant protective association between HCV infection and gestational diabetes (Odds ratio [OR]: 0.83; 95% CI: 0.76-0.96); but this was attenuated with adjustment for confounding variables (Adjusted odds ratio [AOR]: 0.88; 95% CI: 0.76, 1.02). There was no association between HCV and gestational hypertension (AOR: 1.03; 95% CI: 0.91, 1.16) or eclampsia (AOR: 1.15; 95% CI: 0.69, 1.93). Results from the race stratified models were similar to the non-stratified summary models.
We observed no statistically significant associations between maternal HCV infection with maternal health outcomes. Although, our analysis did indicate that HCV may lower the risk of gestational diabetes, this may be attributable to confounding. Studies utilizing more accurately measured HCV infection including those collecting type and timing of testing, and timing of infection are warranted to ensure HCV does not adversely impact maternal and/or fetal health. Particularly in the absence of recommended therapy for HCV during pregnancy.
自 2009 年以来，美国孕妇的丙型肝炎病毒（HCV）感染率呈上升趋势。现有的 HCV 感染和母婴结局的证据有限；因此，我们使用出生证明数据来调查 HCV 感染与母婴健康结局之间的关系。
我们使用了 2017 年美国出生证明数据集（一个包含 140 万份出生记录的横截面），以评估 HCV 感染与妊娠期糖尿病、妊娠高血压和子痫前期之间的关联。潜在的混杂变量包括产前护理、年龄、教育、吸烟、性传播感染（STI）、体重指数（BMI）和怀孕期间体重增加。我们将分析仅限于初次单胎妊娠的女性。使用逻辑回归模型估计比值比，并分别测试白人女性和黑人女性的模型。
我们样本中只有 0.31%的女性感染了 HCV（n=4412）。在未调整的模型中，我们观察到 HCV 感染与妊娠期糖尿病之间存在适度显著的保护关联（比值比[OR]：0.83；95%置信区间：0.76-0.96）；但在校正混杂变量后，这种关联减弱（调整后的比值比[AOR]：0.88；95%置信区间：0.76，1.02）。HCV 与妊娠高血压（AOR：1.03；95%置信区间：0.91，1.16）或子痫前期（AOR：1.15；95%置信区间：0.69，1.93）之间没有关联。按种族分层模型的结果与非分层汇总模型相似。
我们没有观察到母体 HCV 感染与母婴健康结局之间存在统计学上显著的关联。尽管我们的分析确实表明 HCV 可能降低妊娠期糖尿病的风险，但这可能归因于混杂因素。需要进行研究，使用更准确地测量 HCV 感染的方法，包括收集检测的类型和时间，以及感染的时间，以确保 HCV 不会对母婴健康产生不利影响。特别是在怀孕期间不推荐 HCV 治疗的情况下。
