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Only 30% of HCV-exposed infants screened for infection
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The prevalence of hepatitis C infection among one cohort of pregnant women increased by 60% between 2006 and 2014, with only 30% of infants born to infected mothers screened for the infection, according to a retrospective cohort study published in Pediatrics.
“This problem is likely widespread beyond our area,” Catherine Chappell, MD, MSc, from the departments of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh and Magee-Womens Research Institute, told Infectious Diseases in Children. “Some reasons as to why an infant would not be screened for hepatitis C might include that the pediatrician does not know about the exposure because mothers might worry about the stigma, medical records related to the mother’s infection might not transfer to the baby’s records or exposure may have been forgotten by the time screening is done at 18 months of age.”
To examine the prevalence of HCV infection in pregnant women and how often neonates are screened for the infection, the researchers conducted a population-based retrospective cohort study that included pregnant women who gave birth between 2006 and 2014. All women were categorized as infected or uninfected with HCV, a status that the researchers confirmed through billing data. Records associated with infants that were linked to their mothers’ records were recognized and inspected for HCV status.
Furthermore, linked data related to the infant were used to determine which well-child services were received. For this study, Chappell and colleagues specifically observed whether an infant was tested for the presence of hemoglobin or lead testing, or both, after the infant turned 9 months of age.
Of the 87,924 women who gave birth in the cohort, 1.2% were infected with HCV. This prevalence, according to the researchers, demonstrated an increase of 60%. Mothers who were infected were more likely to be younger than 30 years of age (67% vs. 53%; P < .001), white (93% vs. 72%; P < .001) and supported through Medicaid (77% vs. 29%; P < .001). Chappell and colleagues also observed that mothers with HCV infection were more likely to have an opiate use disorder (68% vs. 1%; P < .001).
Maternal infection status had specific effects on the outcomes of their children, with those born to HCV-infected mothers having a higher likelihood of being born preterm (< 37 weeks’ gestation; 22% vs. 10%; P < .001) and to have a low birth weight (<2,500 g; 23% vs. 8%; P < .001).
When infant records were used to determine testing and well-child services received by HCV-exposed infants, the researchers observed that 31% of infants received these services. Only 30% of these infants were screened for the infection.
“I would counsel mothers and inform them that the risk of transmission is between 2% and 8%,” Chappell said. “They must tell their child’s pediatrician about the exposure so that the infant can be tested and be proactive. Effective treatments will soon be available for children, so it is better to know about the infection so that the child can be treated early.” – by Katherine Bortz
Disclosures: Chappell reported receiving research funding from Gilead Sciences through Magee-Womens Research Institute and having served as a consultant for Gilead Sciences. Additionally, Chappell also reported receiving research funding through Magee-Womens Research Institute from Merck. Please see the study for a full list of the other authors’ relevant financial disclosures.
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