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Effect of cesarean section on the risk of perinatal transmission of hepatitis C virus from HCV-RNA+/HIV− mothers: a meta-analysis

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Hepatitis C virus (HCV) vertical transmission is considered the main route of HCV infection in children. Some authors have stated that cesarean section (C/S) can reduce perinatal HCV transmission. However, the study findings are heterogeneous and high-quality studies are lacking.

Aims

To evaluate the effect of mode of delivery on the risk of perinatal mother-to-infant transmission of HCV.

Methods

Only the peer-reviewed published studies that compared perinatal transmission rate of HCV in elective or emergency cesarean section with vaginal delivery in HCV-RNA+/HIV− mothers were included. We applied the random effect model of DerSimonian and Laird method with heterogeneity and sensitivity analyses.

Results

We identified 8 studies that involved 641 unique mother–infant pairs which fulfilled our inclusion criteria. Aggregation of study results did not show a significant decrease in HCV vertical transmission among study (mothers who underwent C/S) versus control (mothers who gave birth vaginally) patients [pooled odds ratio, 1.1 (95% CI 0.45–2.67)]. The P value was 0.35 for our test of heterogeneity.

Conclusions

Our meta-analysis suggests that C/S does not decrease perinatal HCV transmission from HCV-RNA+/HIV− mothers to infants.

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References

  1. Newell ML, Pembrey L (2002) Mother-to-child transmission of hepatitis C virus infection. Drugs Today (Barc) 38:321–337

    Article  Google Scholar 

  2. Pembrey L, Newell ML, Peckham C (2003) Is there a case for hepatitis C infection screening in the antenatal period? J Med Screen 10:161–168

    Article  PubMed  Google Scholar 

  3. Hayashida A, Inaba N, Oshima K et al (2007) Re-evaluation of the true rate of hepatitis C virus mother-to-child transmission and its novel risk factors based on our two prospective studies. J Obstet Gynaecol Res 33:417–422

    Article  PubMed  Google Scholar 

  4. Tovo Pier-Angelo, Pembrey L (2005) A significant sex—but not elective cesarean section—effect on mother-to-child transmission of hepatitis C virus infection. J Infect Dis 192:1872–1879

    Article  Google Scholar 

  5. Gibb DM, Goodall RL, Dunn DT et al (2000) Mother-to-child transmission of hepatitis C virus: evidence for preventable peripartum transmission. Lancet 356:904–907

    Article  CAS  PubMed  Google Scholar 

  6. Pembrey L, Tovo PA (2001) Marie-Louise Newell effects of mode of delivery and infant feeding on the risk of mother-to-child transmission of hepatitis C virus. European Paediatric Hepatitis C Virus Network. BJOG 108:371–377

    Google Scholar 

  7. Mok J, Pembrey L, Tovo PA et al (2005) When does mother to child transmission of hepatitis C virus occur? Arch Dis Child Fetal Neonatal Ed 90:F156–F160

    Article  CAS  PubMed  Google Scholar 

  8. Thomas SL, Newell ML, Peckham CS et al (1998) A review of hepatitis C virus (HCV) vertical transmission: risks of transmission to infants born to mothers with and without HCV viraemia or human immunodeficiency virus infection. Int J Epidemiol 27:108–117

    Article  CAS  PubMed  Google Scholar 

  9. Borenstein M, Hedges LV, Higgins JPT et al (2009) Introduction to meta-analysis. Wiley, UK

    Book  Google Scholar 

  10. Petitti DB (2000) Meta-analysis, decision analysis, and cost-effectiveness analysis: methods for quantitative synthesis in medicine. Oxford University Press, New York

    Google Scholar 

  11. Higgins JP, Thompson SG, Deeks JJ et al (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560

    Article  PubMed  Google Scholar 

  12. Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50:1088–1101

    Article  CAS  PubMed  Google Scholar 

  13. Egger M, Davey Smith G, Schneider M et al (1997) Bias in meta-analysis detected by a simple graphical test. BMJ 315:629–634

    CAS  PubMed  Google Scholar 

  14. Tajiri H, Miyoshi Y, Funada S et al (2001) Prospective study of mother-to-infant transmission of hepatitis C virus. Pediatr Infect Dis J 20:10–14

    Article  CAS  PubMed  Google Scholar 

  15. Syriopoulou V, Nikolopoulou G, Daikos GL et al (2005) Mother to child transmission of hepatitis C virus: rate of infection and risk factors. Scand J Infect Dis 37:350–353

    Article  PubMed  Google Scholar 

  16. Hillemanns P, Dannecker C, Kimmig R et al (2000) Obstetric risks and vertical transmission of hepatitis C virus infection in pregnancy. Acta Obstet Gynecol Scand 79:543–547

    Article  CAS  PubMed  Google Scholar 

  17. Paccagnini S, Principi N, Massironi E et al (1995) Perinatal transmission and manifestation of hepatitis C virus infection in a high risk population. Pediatr Infect Dis J 14:195–199

    Article  CAS  PubMed  Google Scholar 

  18. Granovsky MO, Minkoff HL, Tess BH et al (1998) Hepatitis C virus infection in the mothers and infants cohort study. Pediatrics 102:355–359

    Article  CAS  PubMed  Google Scholar 

  19. Fischler B, Lindh G, Lindgren S et al (1996) Vertical transmission of hepatitis C virus infection. Scand J Infect Dis 28:353–356

    Article  CAS  PubMed  Google Scholar 

  20. Marine-Barjoan E, Berrebi A, Giordanengo V et al (2007) HCV/HIV co-infection, HCV viral load and mode of delivery: risk factors for mother-to-child transmission of hepatitis C virus? AIDS 21:1811–1815

    Article  PubMed  Google Scholar 

  21. Zanetti AR, Tanzi E, Romano L et al (1998) A prospective study on mother-to-infant transmission of hepatitis C virus. Intervirology 41:208–212

    Article  CAS  PubMed  Google Scholar 

  22. McMenamin MB, Jackson AD, Lambert J et al (2008) Obstetric management of hepatitis C-positive mothers: analysis of vertical transmission in 559 mother–infant pairs. Am J Obstet Gynecol 199:315 e1–e5

    Google Scholar 

  23. Shebl FM, El-Kamary SS, Saleh DA et al (2009) Prospective cohort study of mother-to-infant infection and clearance of hepatitis C in rural Egyptian villages. J Med Virol 81:1024–1031

    Article  CAS  PubMed  Google Scholar 

  24. Mast EE, Hwang LY, Seto DS et al (2005) Risk factors for perinatal transmission of hepatitis C virus (HCV) and the natural history of HCV infection acquired in infancy. J Infect Dis 192:1880–1889

    Article  PubMed  Google Scholar 

  25. Okamoto M, Nagata I, Murakami J et al (2000) Prospective reevaluation of risk factors in mother-to-child transmission of hepatitis C virus: high virus load, vaginal delivery, and negative anti-NS4 antibody. J Infect Dis 182:1511–1514

    Article  CAS  PubMed  Google Scholar 

  26. La Torre A, Biadaioli R, Capobianco T et al (1998) Vertical transmission of HCV. Acta Obstet Gynecol Scand 77:889–892

    Article  CAS  PubMed  Google Scholar 

  27. Ceci O, Margiotta M, Marello F et al (2001) Vertical transmission of hepatitis C virus in a cohort of 2,447 HIV-seronegative pregnant women: a 24-month prospective study. J Pediatr Gastroenterol Nutr 33:570–575

    Article  CAS  PubMed  Google Scholar 

  28. Kassem AS, El-Nawawy AA, Massoud MN et al (2000) Brief report. Prevalence of hepatitis C virus (HCV) infection and its vertical transmission in Egyptian pregnant women and their newborns. J Trop Pediatr 46:231–233

    Article  CAS  PubMed  Google Scholar 

  29. Ferrero S, Lungaro P, Bruzzone BM et al (2003) Prospective study of mother-to-infant transmission of hepatitis C virus: a 10-year survey (1990–2000). Acta Obstet Gynecol Scand 82:229–234

    PubMed  Google Scholar 

  30. Spencer JD, Latt N, Beeby PJ et al (1997) Transmission of hepatitis C virus to infants of human immunodeficiency virus-negative intravenous drug-using mothers: rate of infection and assessment of risk factors for transmission. J Viral Hepat 4:395–409

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

The authors declare that they have no conflicts of interest relevant to the manuscript.

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Authors and Affiliations

  1. Research Center for Gastroenterology and Liver Disease, Ground floor of Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Mollasadra Ave., Vanak Sq., P.O. Box 14155-3651, Tehran, Iran

    Mohammad Ebrahim Ghamar Chehreh, Seyed Vahid Tabatabaei, Shahab Khazanehdari & Seyed Moayed Alavian

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  1. Mohammad Ebrahim Ghamar Chehreh
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  2. Seyed Vahid Tabatabaei
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  3. Shahab Khazanehdari
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  4. Seyed Moayed Alavian
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Correspondence to Seyed Moayed Alavian.

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Ghamar Chehreh, M.E., Tabatabaei, S.V., Khazanehdari, S. et al. Effect of cesarean section on the risk of perinatal transmission of hepatitis C virus from HCV-RNA+/HIV− mothers: a meta-analysis. Arch Gynecol Obstet 283, 255–260 (2011). https://doi.org/10.1007/s00404-010-1588-9

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  • DOI: https://doi.org/10.1007/s00404-010-1588-9

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