Reducing risk for mother-to-infant transmission of hepatitis C virus: a systematic review for the U.S. Preventive Services Task Force.
Abstract
BACKGROUND: Mother-to-infant transmission is the leading cause of childhood hepatitis C virus (HCV) infection, with up to 4000 new cases each year in the United States. PURPOSE: To evaluate effects of mode of delivery, labor management strategies, and breastfeeding practices on risk for mother-to-infant transmission of HCV. DATA SOURCES: MEDLINE (1947 to May 2012), the Cochrane Library Database, clinical trial registries, and reference lists. STUDY SELECTION: Randomized trials and observational studies on mode of delivery, labor management strategies, and breastfeeding practices and risk for mother-to-infant transmission of HCV. DATA EXTRACTION: Investigators abstracted and reviewed study details and quality using predefined criteria. DATA SYNTHESIS: Eighteen observational studies evaluated the association between mode of delivery, labor management strategies, or breastfeeding practices and risk for mother-to-infant HCV transmission. Fourteen studies (2 good-quality, 4 fair-quality, and 8 poor-quality studies) found no clear association between mode of delivery (vaginal versus cesarean delivery) and risk for transmission. Two studies (1 good-quality and 1 poor-quality study) reported an association between prolonged duration of ruptured membranes and increased risk for transmission. Fourteen studies (2 good-quality, 2 fair-quality, and 10 poor-quality studies) found no association between breastfeeding and risk for transmission. LIMITATIONS: Only English-language articles were included. Studies were observational, and most had important methodological shortcomings, including failure to adjust for potential confounders and small sample sizes. CONCLUSION: No intervention has been clearly demonstrated to reduce the risk for mother-to-infant HCV transmission. Avoidance of breastfeeding does not seem to be indicated for reducing transmission risk. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.
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More than six of every 100 infants born to women with HCV infection become infected; this infection occurs predominantly during or near delivery, and no treatment or delivery method has been demonstrated to decrease this risk.
“Although the rate of transmission is highly variable, more than six of every 100 infants born to women with HCV infection become infected; this infection occurs predominantly during or near delivery, and no treatment or delivery method (e.g., cesarean delivery) has been demonstrated to decrease this risk (1375).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [1375]
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References 38 · Cited by 194
- Authors
- Cottrell, E. B., Chou, R., Wasson, N., Rahman, B., & Guise, J.-M.
- Affiliations
- Oregon Health & Science University (US)
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2013-01-15
- Volume
- 158
- Issue
- 2
- Pages
- 109-113
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2003977995
- Cited by
- 194
- References
- 38
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 11 · 2023: 7 · 2022: 9 · 2021: 15 · 2020: 17 · 2019: 23 · 2018: 23 · 2017: 12 · 2016: 20 · 2015: 18 · 2014: 17 · 2013: 12 · 2012: 2
- FWCI
- 2.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (290-2007-10057-I)
- Topics
- Health Sciences › Medicine › Hepatology › Hepatitis C virus research
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- hepatitis C virus, mother-to-child transmission, perinatal transmission, mode of delivery, cesarean section, vaginal delivery, labor management, prolonged rupture of membranes, breastfeeding
- MeSH terms
- Breast Feeding, Female, Fetal Monitoring, Hepatitis C, Humans, Infant, Labor, Obstetric, Pregnancy, Pregnancy Complications, Infectious, Infectious Disease Transmission, Vertical, Perinatal Care, Delivery, Obstetric, Risk Reduction Behavior
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