Reducing risk for mother-to-infant transmission of hepatitis C virus

A systematic review for the U.S. preventive services task force

Erika Cottrell, Roger Chou, Ngoc Wasson, Basmah Rahman, Jeanne-Marie Guise

Research output: Contribution to journalArticle

84 Citations (Scopus)

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-toinfant 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 poorquality 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.

Original languageEnglish (US)
Pages (from-to)109-113
Number of pages5
JournalAnnals of Internal Medicine
Volume158
Issue number2
StatePublished - 2013
Externally publishedYes

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Advisory Committees
Hepacivirus
Mothers
Breast Feeding
Observational Studies
Information Storage and Retrieval
Health Services Research
Virus Diseases
MEDLINE
Sample Size
Libraries
Registries
Language
Research Personnel
Clinical Trials
Databases
Membranes

ASJC Scopus subject areas

  • Internal Medicine

Cite this

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title = "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-toinfant 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 poorquality 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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N2 - 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-toinfant 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 poorquality 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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