Pregnancy and pregnancy outcome in hepatitis C type 1b

A large cohort of rhesus‐negative women in Ireland were inadvertently infected with hepatitis C virus following exposure to contaminated anti‐D immunoglobulin in 1977–8. This major iatrogenic episode was discovered in 1994. We studied 36 women who had been infected after their first pregnancy, and compared them to an age‐ and parity‐matched control group of rhesus‐positive women. The presence of hepatitis C antibody was confirmed in all 36 by enzyme‐linked immunosorbent assay and by recombinant immunoblot assay, while 26 (72%) of the cohort were HCV‐RNA‐positive (type 1b) on PCR testing. In the 20 years post‐infection, all members of the study group had at least one pregnancy, and mean parity was 3.5. They had a total of 100 pregnancies and 85 of these went to term. There were four premature births, one being a twin pregnancy, and 11 spontaneous miscarriages. One miscarriage occurred in the pregnancy following HCV infection. There were two neonatal deaths due to severe congenital abnormalities in the PCR‐positive women. Of the children born to HCV‐RNA positive mothers, only one (2.3%) tested positive for the virus. Significant portal fibrosis on liver biopsy was confined to HCV‐RNA‐positive mothers apart from one single exception in the antibody‐positive HCV‐RNA‐negative group. Comparison with the control group showed no increase in spontaneous miscarriage rate, and no significant difference in obstetric complications; birth weights were similar for the two groups.