Associations of hepatitis B and C in women aged 15–49 years with neonatal preterm birth in 66 high‐income countries, 1990–2019

Objective To assess the associations between hepatitis B and C in women aged 15–49 years and neonatal preterm birth in high‐income countries (HICs). Methods This ecological study collected hepatitis B and C prevalence data in women aged 15–49 years and age‐standardized incidence rates (ASIRs) of neonatal preterm birth in HICs in 1990–2019 from the Global Burden of Disease study. Estimated annual percentage changes (EAPCs) in hepatitis B and C prevalence and ASIRs of neonatal preterm birth were calculated to quantify their temporal trends. Pearson correlation tests and generalized additive mixed models were used to estimate the associations between hepatitis B and C prevalence and ASIR of neonatal preterm birth. Results Among women aged 15–49 years in HICs, hepatitis B prevalence increased only in the Northern Mariana Islands (EAPC, 0.16 [95% confidence interval (CI), 0.05–0.27]) and the United Kingdom (EAPC, 0.08 [95% CI, 0.04–0.12]) and hepatitis C prevalence increased in more than 20% of HICs in 1990–2019, with the largest increase in Belgium (EAPC, 1.00 [95% CI, 0.65–1.35]). Nearly 80% of HICs showed an increasing trend in ASIR of neonatal preterm birth in 1990–2019, with the largest increase in Greece (EAPC, 3.91 [95% CI, 3.65–4.18]). A positive association between hepatitis C prevalence in women aged 15–49 years and ASIR of neonatal preterm birth was observed in Pearson correlation tests and generalized additive mixed models (P ≤ 0.01). Conclusion ASIR of neonatal preterm birth was associated with hepatitis C prevalence in women aged 15–49 years in HICs. Universal screening for hepatitis C virus is recommended at least once for women of reproductive age and during each pregnancy. Synopsis Neonatal preterm birth is significantly associated with hepatitis C in women aged 15–49 years in 66 high‐income countries worldwide.