Increased risk of mother-to-infant transmission of hepatitis C virus by intrapartum infantile exposure to maternal blood
Increased risk of mother-to-infant transmission of hepatitis C virus by intrapartum infantile exposure to maternal blood
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DOI：
10.1086/367704
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发表时间：
2003-02-01
影响因子：
6.4
通讯作者：
Holzmann, H
中科院分区：
文献类型：
--
作者：
Steininger, C;Kundi, M;Holzmann, H
回顾性分析73例丙型肝炎病毒（HCV）感染孕妇的病毒学和临床资料，采用Logistic回归分析探讨HCV垂直传播的危险因素。82%的HCV感染的母亲在怀孕期间HCV-RNA阳性，10%合并感染人类免疫缺陷病毒（HIV）。HCV感染9例，HIV感染1例，无HIV-HCV合并感染。在阴道分娩中，将HCV传播给婴儿的母亲的平均HCV载量高于未将HCV传播给婴儿的母亲（8.1 x 10（5）对1.4 x 10（4）拷贝/mL; P = 0.056）。脐带血pH值降低（相对危险度，3.9; P = 0.04）或阴道分娩时会阴或阴道撕裂伤的发生（相对危险度，6.4; P = 0.028）显著增加了HCV垂直传播的风险。总之，母体高病毒血症、婴儿缺氧和分娩时暴露于病毒污染的母体血液增加了经阴道分娩时HCV传播的风险。因此，在某些情况下，剖宫产可以降低垂直HCV传播的风险。
Virological and clinical data from 73 hepatitis C virus (HCV)-infected pregnant women who gave birth to 75 children were merged retrospectively, by logistic regression analysis, to investigate risk factors for vertical transmission of HCV. Eighty-two percent of the HCV-infected mothers were HCV-RNA-positive during pregnancy, and 10% were coinfected with human immunodeficiency virus (HIV). Nine children were HCV infected, 1 was HIV infected, but none was HIV-HCV coinfected. Among vaginal deliveries, the mean HCV load of mothers who transmitted HCV to their infants was higher than that of those who did not (8.1 x 10(5) vs. 1.4 x 10(4) copies/mL; P = .056). A reduction in umbilical cord-blood pH (relative risk, 3.9; P = .04) or the occurrence of perineal or vaginal laceration (relative risk, 6.4; P. = .028) during vaginal delivery significantly increased the risk of vertical HCV transmission. In conclusion, high maternal viremia, infantile hypoxia, and intrapartum exposure to virus-contaminated maternal blood increased the risk of HCV transmission during vaginal deliveries. Consequently, cesarean section may reduce the risk of vertical HCV transmission in selected cases.