Epidemiology

Acute hepatitis A tied to pregnancy complications

Last Updated: 2006-05-03 15:19:44 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Acute hepatitis A infection in pregnant women is associated with high rates of gestational complications and preterm labor, according to Israeli researchers.

In the April issue of Gastroenterology, Dr. Eran Elinav of Hadassah-Hebrew Medical Center, Jerusalem and colleagues note that while the disease is the most common type of acute hepatitis, there are few reports of its possible side effects during pregnancy.

To investigate, the researchers retrospectively reviewed a database covering 25 years and close to 80,000 pregnancies. The team found 13 cases of second and third trimester infection.

Nine of the patients (69%) developed complications. These consisted of premature contractions in 4 patients, placental separation in 2, premature rupture of the membranes in 2 patients and vaginal bleeding in the remaining patient.

In 8 of these patients, the complications led to preterm labor at a median of 34 gestational weeks.

Overall, 12 of the births were vaginal. There was one case of fetal distress and meconium was seen in amniotic fluid in two other pregnancies.

Median birthweight was 1778 g in preterm deliveries and 3040 g in term deliveries. Neonatal serum hepatitis A RNA levels were checked in 4 cases and were found to be negative. Overall maternal and neonatal outcomes were generally favorable.

"Hepatitis A vaccination is considered safe during pregnancy," Dr. Elinav told Reuters Health. "Thus, we believe that the hepatology and obstetric communities should promote a prospective evaluation, to assess the implications of the addition of hepatitis A serology and vaccination to the battery of pre-pregnancy screening examinations in endemic areas. This may prevent this potentially harmful, yet totally avoidable disease."

Gastroenterol 2006;130:1129-1134.