Maternal hepatitis B or C status and the long-term risk of gastrointestinal morbidity for offspring: A population-based cohort study

Liver Int. 2019 Nov;39(11):2046-2051. doi: 10.1111/liv.14193. Epub 2019 Jul 31.

Abstract

Background: More than 360 million people have chronic hepatitis B or C (HBV/HCV) infection worldwide, many of which are women at childbearing age. While the risk of perinatal HBV/HCV has been well established, the long-term implications on offspring health, have been less studied. We aimed to evaluate the association between maternal HBV/HCV carrier status and long-term gastrointestinal (GI) morbidities in offspring.

Aims & methods: A population-based cohort analysis compared the risk for long-term childhood GI morbidities in children born to HBV/HCV carrier mothers vs the risk in those who were born to noncarriers. Childhood GI morbidities were predefined based on ICD-9 codes, as recorded in hospital medical files. Children with congenital malformations and multiple gestations were excluded from the analysis. A Kaplan-Meier survival curve was constructed to compare the cumulative GI morbidities over time, and a Cox proportional hazards model was used to control for confounders.

Results: During the study period (1991-2014), 242 342 newborns met the inclusion criteria: 771 (0.3%) were born to HBV/HCV mothers and 241 571 (99.7%) were not. The median follow-up was 10.51 years (0-18 years). Offspring to HBV/HCV mothers had a higher incidence of GI diseases (9.3% vs 5.4%, OR = 1.82; 95% CI 1.43-2.32; Kaplan-Meier log-rank = 0.001). The increased risk remained significant in the Cox proportional hazards models, which adjusted for gestational age, mode of delivery and pregnancy complications (adjusted HR = 2.26, 95% CI: 1.79-2.85; P < .001).

Conclusion: Maternal HBV or HCV carrier status is an independent risk factor for long-term the GI morbidity of offspring.

Keywords: follow-up studies; hepatitis B; hepatitis C; mothers; pregnancy.

MeSH terms

  • Adolescent
  • Adult
  • Carrier State
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Gastrointestinal Diseases / epidemiology*
  • Gestational Age
  • Hepatitis B / epidemiology*
  • Hepatitis C / epidemiology*
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Israel / epidemiology
  • Kaplan-Meier Estimate
  • Male
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology*
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Proportional Hazards Models
  • Risk Factors
  • Young Adult