Comparison of foeto-maternal outcome in pregnant women with hepatitis E - A review of 12 years

J Pak Med Assoc. 2017 Apr;67(4):538-543.

Abstract

Objective: To compare adverse maternal and foetal outcome in pregnant women with hepatitis E immunoglobulin M reactive versus non-reactive.

Methods: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of pregnant patients at any gestational age with clinical and biochemical evidence of hepatitis E from January 2002 and December 2014. . Maternal and perinatal outcome of the subjects were analysed. SPSS 20 was used for data analysis.

Results: Out of the 200 subjects, 168(84 %) were hepatitis E immunoglobulin M reactive and 32(16%) were non-reactive. The overall mean age was 26.7±4.5 years. Also, 12(7%) patients in the immunoglobulin M reactive group were admitted to intensive care unit compared to no one from the non-reactive group. Similarly fulminant hepatic failure was seen in 12(7.1%) patients in the immunoglobulin M reactive group compared to no one in the other group. Post-partum haemorrhage was more frequent in the immunoglobulin M reactive group compared to the non-reactive group. There were 5(3%) maternal deaths in the reactive group compared to no death in the other group. Moreover, 34(20.2%) neonates of the immunoglobulin M reactive group needed neonatal intensive care unit admission compared to none in the non-reactive group. There were 4(2.4%) neonatal deaths in the reactive group.

Conclusions: Participants in the immunoglobulin M reactive group had a higher percentage of adverse foeto-maternal outcomes compared to the non-reactive group.

Keywords: Hepatitis E, Fulminant hepatic failure, Maternal mortality..

MeSH terms

  • Adult
  • Case-Control Studies
  • Female
  • Hepatic Encephalopathy / epidemiology
  • Hepatic Encephalopathy / etiology
  • Hepatitis Antibodies / immunology
  • Hepatitis E / complications
  • Hepatitis E / epidemiology*
  • Hepatitis E / immunology
  • Humans
  • Immunoglobulin M / immunology
  • Infant
  • Infant Mortality
  • Infant, Newborn
  • Intensive Care Units / statistics & numerical data
  • Intensive Care Units, Neonatal / statistics & numerical data
  • Liver Failure, Acute / epidemiology*
  • Liver Failure, Acute / etiology
  • Maternal Mortality
  • Pakistan
  • Postpartum Hemorrhage / epidemiology*
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology*
  • Pregnancy Complications, Infectious / immunology
  • Young Adult

Substances

  • Hepatitis Antibodies
  • Immunoglobulin M