Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection

Patra, Sharda ; Kumar, Ashish ; Trivedi, Shubha Sagar ; Puri, Manju ; Sarin, Shiv Kumar (2007) Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection Annals of Internal Medicine, 147 (1). pp. 28-33. ISSN 0003-4819

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Official URL: http://www.annals.org/content/147/1/28.short

Abstract

Background: Hepatitis E virus (HEV) infection is known to cause severe liver disease in pregnant women. It is unclear whether obstetric and fetal outcomes are worse in pregnant women with HEV infection than in women with other forms of viral hepatitis. Objective: To compare maternal, obstetric, and fetal outcomes in pregnant women with acute viral hepatitis caused by HEV and other hepatitis viruses. Design: Observational cohort. Setting: Tertiary care hospital, New Delhi, India. Patients: 220 consecutive pregnant women presenting with jaundice caused by acute viral hepatitis. Measurements: Maternal mortality and medical complications, obstetric complications, deliveries, and fetal outcomes. Results: Infection with HEV caused acute viral hepatitis in 60% of included women. Fulminant hepatic failure was more common (relative risk, 2.7 [95% CI, 1.7 to 4.2]; P = 0.001) and maternal mortality was greater (relative risk, 6.0 [CI, 2.7 to 13.3]; P < 0.001) in HEV-infected women than in non-HEV-infected women. Women with HEV infection were more likely than those with other forms of viral hepatitis to have obstetric complications (relative risk, 4.1 [CI, 1.7 to 10.2] for antepartum hemorrhage and 1.9 [CI, 1.3 to 2.7] for intrauterine fetal death; P < 0.001 for both) and poor fetal outcomes (relative risk, 1.2 [CI, 1.0 to 1.4] for preterm delivery [P = 0.005] and 1.8 [CI, 1.2 to 2.5] for stillbirth [P = 0.026]). Limitations: The findings may not apply to community settings, to women who are asymptomatic or have only minor symptoms, or in the setting of an HEV epidemic. Conclusions: Pregnant women with jaundice and acute viral hepatitis caused by HEV infection had a higher maternal mortality rate and worse obstetric and fetal outcomes than did pregnant women with jaundice and acute viral hepatitis caused by other types of viral hepatitis.

Item Type:Article
Source:Copyright of this article belongs to American College of Physicians.
ID Code:44287
Deposited On:21 Jun 2011 07:38
Last Modified:18 May 2016 01:01

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