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Q J Med 2000; 93: 597-601
© 2000 Association of Physicians

Pregnancy and pregnancy outcome in hepatitis C type 1b

T. Jabeen, B. Cannon, J. Hogan, M. Crowley, C. Devereux, L. Fanning, E. Kenny-Walsh, F. Shanahan and M.J. Whelton

From the Departments of Medicine, Pathology, and Statistics, Cork University Hospital, and University College Cork, Cork, Ireland

Received 8 May 2000 and in revised form 4 July 2000

A large cohort of rhesus-negative women in Ireland were inadvertently infected with hepatitis C virus following exposure to contaminated anti-D immunoglobulin in 1977–8. This major iatrogenic episode was discovered in 1994. We studied 36 women who had been infected after their first pregnancy, and compared them to an age- and parity-matched control group of rhesus-positive women. The presence of hepatitis C antibody was confirmed in all 36 by enzyme-linked immunosorbent assay and by recombinant immunoblot assay, while 26 (72%) of the cohort were HCV-RNA-positive (type 1b) on PCR testing. In the 20 years post-infection, all members of the study group had at least one pregnancy, and mean parity was 3.5. They had a total of 100 pregnancies and 85 of these went to term. There were four premature births, one being a twin pregnancy, and 11 spontaneous miscarriages. One miscarriage occurred in the pregnancy following HCV infection. There were two neonatal deaths due to severe congenital abnormalities in the PCR-positive women. Of the children born to HCV-RNA positive mothers, only one (2.3%) tested positive for the virus. Significant portal fibrosis on liver biopsy was confined to HCV-RNA-positive mothers apart from one single exception in the antibody-positive HCV-RNA-negative group. Comparison with the control group showed no increase in spontaneous miscarriage rate, and no significant difference in obstetric complications; birth weights were similar for the two groups.

Address correspondence to Dr M.J. Whelton, Department of Medicine, Cork University Hospital, Wilton, Cork, Ireland


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