Risk factors and adverse outcomes associated with hepatitis C virus in pregnancy.

Objectives: To evaluate maternal sociodemographic factors and adverse pregnancy outcomes associated with hepatitis C virus (HCV) infection during pregnancy in a large population of live births.

Methods: Retrospective analysis of the United States (US) Centers for Disease Control and Prevention Natality Live Birth database (2016-2021). All births were eligible for inclusion. Deliveries with missing data on HCV infection were excluded. Multiple sociodemographic factors and adverse pregnancy and neonatal outcomes were compared between pregnancies complicated by maternal HCV infection and those without HCV. Multivariable logistic regression was utilized to evaluate the association of sociodemographic factors with HCV and adjust outcomes for potential confounders.

Results: Of the 22,604,938 live births included, 107,761 (0.48 %) were complicated by maternal HCV. Patients with HCV in pregnancy were more likely to be advanced maternal age, have Medicaid insurance, or smokers. In addition, HCV in pregnancy was associated with higher risks of concurrent infections with hepatitis B virus, syphilis, gonorrhea, or chlamydia. HCV was associated with an increased risk of preterm birth <37 weeks, low birthweight, congenital anomalies at birth, low 5-min Apgar scores, NICU admission, antibiotic treatment for suspected neonatal sepsis, as well as immediate and prolonged ventilation.

Conclusions: Based on this recent, large US population cohort, HCV in pregnancy is more commonly associated with certain sociodemographic factors and several adverse pregnancy and neonatal outcomes. These data are an important step in the attempt to identify at-risk patients and employ strategies to better manage and optimize care for these pregnancies.