Pregnancy and pregnancy outcome in hepatitis C type 1b

A large cohort of rhesus-negative women in Ireland were inadvertently infec ted with hepatitis C virus following exposure to contaminated anti-D immuno globulin in 1977-8. This major iatrogenic episode was discovered in 1994. W e studied 36 women who had been infected after their first pregnancy, and c ompared 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 enz yme-linked immunosorbent assay and by recombinant immunoblot assay, while 2 6 (72%) of the cohort were HCV-RNA-positive (type 1b) on PCR testing. In th e 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 tw in pregnancy, and 11 spontaneous miscarriages. One miscarriage occurred in the pregnancy following HCV infection. There were two neonatal deaths due t o severe congenital abnormalities in the PCR-positive women. Of the childre n 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 increas e in spontaneous miscarriage rate, and no significant difference in obstetr ic complications; birth weights were similar for the two groups.