Study On The Status And Risk Factors Of Hepatitis C Virus Infection Among Pregnant Women

Objective To investigate the prevalence of anti-HCV positive incidence among pregnant women in Chinese mainland,the database is based on the obstetric monitoring platform of provincial third-A specialized women and children’s health hospital,to analyze the status and trend of Hepatitis C virus（HCV）infection among pregnant women in Lanzhou city,and identify the possible risk factors of HCV infection among pregnant women by medical record information.So as to provide a theoretical basis for the scientific formulation of prevention and control strategies of HCV among pregnant women.Methods（1）We systemically reviewed the anti-HCV positive rates among pregnant women population in Chinese mainland from January 2008 to December 2018,using a single rate meta-analysis method to combine effect-size.（2）The monitoring data of pregnant women in maternity department of provincial third-A specialized women and children’s health hospital in Lanzhou city from 2008 to 2018 were collected,and the annual HCV antibody detection results,basic information and other relevant data among pregnant women also were collected:①Descriptive study was used to analyze the positive status of HCV antibody among pregnant women,the Joinpoint regression model and polynomial regression model were used to analyze the trend of anti-HCV positive rates among pregnant women;②Conditional Logistic regression model was used to explore the risk factors of HCV infection in anti-HCV positive pregnant women.Results 1.A total of 108 studies involving 657 765 individuals were included.Meta-analysis results showed that the overall combined the positive rate of HCV antibody among pregnant women in Chinese was 0.235%（95%CI 0.189%to 0.286%）.The subgroup analysis showed that the positive rate of HCV antibody among pregnant women in western China was the highest 0.291%（95%CI 0.221%to 0.378%）,the northeast China was 0.240%（95%CI 0.099%to 0.442%）and the central China was 0.235%（95%CI 0.016%to 0.319%）,the east China was lowest 0.193%（95%CI 0.119%to 0.281%）;the HCV antibody positive rate of pregnant women from hospital was 0.291%（95%CI 0.221%to 0.372%）higher than that from AIDS surveillance site 0.164%（95%CI 0.122%to 0.207%）.2.This study included a total of 69 620 pregnant women,including 227 HCV antibody positive people,the anti-HCV positive rate was 0.33%（227/69,620）among pregnant women in Lanzhou city,and the range of positive rate is from 0.15%to 0.48%.The results of Joinpoint regression model showed that the anti-HCV positive rate among pregnant women in Lanzhou were increased at an average annual percent change（APC）of 0.61%（95%CI:-7.03%～8.89%）from 2008 to 2018,but the change trend was not statistically significant（P=0.87>0.05）,from 2016 to 2018,the positive rate of anti-HCV showed a decreasing trend（APC=-36.62%,95%CI-74.44%to 57.12%）,the change trend was also not statistically significant（P=0.27>0.05）;The results of polynomial regression model showed that the cubic polynomial had a good fitting effect（AIC=-23.886,residual=0.068）,the fitting results showed that the antiHCV positive rate in maternal population was stable on the whole,but had a downward trend.3.The ratio about parity,history of blood transfusion/blood products,diagnosis and treatment history of invasive medical devices were 48.02%（109/227）,24.67%（56/227）,4.41%（10/227）,with higher compared to those of controls(38.77%（176/454）,1.32%（6/454）,1.98%（9/454）.The results of single factor conditional Logistic regression model showed that occupation,parity,history of blood transfusion/blood products,diagnosis and treatment history of invasive medical devices were associated with pregnant women who infected HCV（x2 values were 11.802,5.937,21.219 and 3.020,all P values<0.1）.Results of multivariate conditional Logistic regression model showed that farmers had lower risk of HCV infection than women with other occupations,with OR value of 0.129（95%CI 0.033 to 0.500）,and the difference was statistically significant.Pregnant women with a history of blood transfusion/blood products were at higher risk of HCV infection compared to women without a history of blood transfusion/blood products（OR=99.755,95%CI 13.751 to 723.683）.Conclusions 1.The prevalence of anti-HCV among pregnant women maintains at a low level between 2008 and 2018 in Chinese mainland,the pregnant women belong to low-risk population of hepatitis C infection.2.From 2008 to 2018,the anti-HCV positive rates among pregnant women showed stable status in Lanzhou,but there was a downward trend.The positive rate of anti-HCV in Lanzhou city was significantly higher than that of pregnant women in mainland China at the same period.3.Occupation and a history of blood transfusion or blood products are risk factor among pregnant women in Lanzhou of hepatitis C infection.The pregnant women who worked as a farmer can reduce the risk of HCV infection,the pregnant women who had a history of blood transfusion or blood products can increase the risk of HCV infection.