Association between hepatitis C infection during pregnancy with maternal and neonatal outcomes: a systematic review and meta-analysis

OBJECTIVE

Studies of possible implications of the maternal hepatitis C virus (HCV) infection in terms of intrauterine fetal growth restriction (IUGR), preterm birth (PTB), low birth weight (LBW) infants, premature rupture of membranes (PROM), maternal and neonatal mortality are limited and inconclusive. Our study aims to assess the impact of HCV on maternal and neonatal outcomes.

MATERIALS AND METHODS

Systematic literature search was done in PubMed, Scopus, and Google Scholar, Cochrane Library, and TRIP databases for all observational studies published from 1st January 1950 to 15th October 2022. The pooled odds ratio (OR) or risk ratio (RR) with a 95% confidence interval (CI) was estimated. STATA version 12.0 software was used for analysis. Heterogeneity among the included articles was evaluated by sensitivity, meta-regression, and publication bias analyses.

RESULTS

A total of 14 studies involving 12,451 HCV (+) and 56,42,910 HCV (-) pregnant women were included in our meta-analysis. Maternal HCV during pregnancy was significantly associated with the increased risk of PTB (OR=1.66, 95% CI: 1.59-1.74), IUGR (OR=2.09, 95% CI: 2.04-2.14) and LBW (OR=1.96, 95% CI: 1.63-2.36) as compared to healthy pregnant women. Subgroup analysis based on ethnicity also suggested a strong association between maternal HCV infection and a higher risk of PTB in Asian and Caucasian populations. Maternal (RR=3.44, 95% CI: 1.85-6.41), as well as neonatal (RR=1.54, 95% CI: 1.18-2.02) mortality was significantly higher in HCV (+) cases.

CONCLUSIONS

Mothers with HCV infection had a markedly increased probability of PTB and/or IUGR and/or LBW. In clinical practice, standard care of treatment and proper monitoring are needed for the pregnant population with HCV infection. Our findings may provide useful information for selecting appropriate therapy methods for HCV-positive pregnant women.

[Effects of Lewis Y oligosaccharide on secretion and gene expression of EGF and EGF-R in mouse embryos]

Implantation is a complicated developmental process. Some hormones and cytokines are involved in the regulation of the implantation by regulating functions of the endometrium and the embryo. Oligosaccharide antigen Lewis Y is specifically expressed on embryo surface and plays an important role in implantation. In this study, effects of Lewis Y on secretion and gene expression of EGF and EGF receptor of the embryo were investigated. Embryos were pre-incubated with Le(Y) specific antibody AH6 for 3 h, then antibody was removed, immuno-dot blots and RT-PCR were used to analyze the secretion of EGF and EGF receptor and their gene expression in the embryo at different times after pre-incubation. The results showed that, when blocked by AH6 antibody for 1.5 h, the secretion and expression of EGF in the embryo were significantly declined, and the alteration was continued to over 6 h; and those of EGF-R were slightly decreased after blocking. The results suggest that Lewis Y oligosaccharide on the surface of embryo may be involved in the regulation of embryo development and implantation, by affecting the expression and secretion of EGF in embryo.