Association of hepatitis C virus infection with risk of gestational diabetes mellitus: A systematic review and meta-analysis

Aim

Whether hepatitis C virus (HCV) infection is associated with the risk of gestational diabetes mellitus (GDM) remains controversial. This study aims to systematically evaluate the impact of HCV infection on GDM risk.

Methods

Seven electronic databases, including PubMed, Embase, Web of Science, Ovid, ScienceDirect, China National Knowledge Infrastructure, and SinoMed, were retrieved for all related studies by October of 2024. Studies on the relationship between HCV infection and GDM risk were included. The quality of included studies was assessed using the Newcastle-Ottawa Scale. A random effects meta-analysis was performed to estimate the overall odds ratio (OR) and 95% confidence intervals (CI) by Stata software.

Results

The analysis included 18 studies comprising 45 567 678 pregnancies. HCV infection was significantly associated with increased GDM risk (pooled OR = 1.21, 95% CI: 1.04–1.40), with substantial heterogeneity (I² = 87.6%). Subgroup analyses demonstrated significant associations in European populations (OR = 1.66, 95% CI: 1.13–2.43; I² = 40.4%), prospective cohort studies (OR = 1.72, 95% CI: 1.33–2.22; I² = 0.0%), human immunodeficiency virus-positive populations (OR = 2.04, 95% CI: 1.04–3.99; I² = 46.2%), and general populations (OR = 1.16, 95% CI: 1.00–1.34; I² = 88.7%). There was a positive but not statistically significant association for the North America population and retrospective studies (p < 0.05), with considerable heterogeneity. The overall results were robust, indicated by sensitivity analysis, and no obvious publication bias was observed according to Begg's test.

Conclusions

HCV infection is positively associated with increased GDM risk. Further studies with diverse representative populations and more rigorous prospective designs are warranted to establish more comprehensive conclusions.