BACKGROUND & AIMS: Hepatitis A virus (HAV) infection is the most common cause of acute hepatitis but is rarely reported during pregnancy. Our aim was to evaluate the impact of acute HAV infection on pregnancy outcome. METHODS: Consecutive admissions of 79,458 pregnant females during a 25-year period were retrospectively reviewed. RESULTS: Thirteen cases of second and third trimester HAV infection were found and evaluated. Nine of the 13 patients (69%) developed gestational complications, including premature contractions (n = 4), placental separation (n = 2), premature rupture of membranes (n = 2), and vaginal bleeding (n = 1). In 8 of these patients, complications led to preterm labor, at a median of 34 gestational weeks (range, 31-37 weeks). Delivery was vaginal in 12 of the 13 cases; fetal distress was noted in a single case, and meconium in amniotic fluid in 2 cases. Median birth weight was 1778 grams and 3040 grams in preterm and term deliveries, respectively (P < .05). Child outcome was favorable in all cases. In 4 cases, neonatal serum HAV RNA levels were measured and found negative. The presence of fever and hypoalbuminemia were associated with delivery at an earlier gestational week. There was a positive relation between gestational week at diagnosis of HAV infection and birth week (r = 0.68, P = .02), suggesting a causality relationship. All mothers featured full recovery from HAV infection. CONCLUSIONS: Acute HAV infection during pregnancy is associated with high risk of maternal complications and preterm labor. HAV serology and maternal vaccination during prepregnancy evaluation should be considered in areas of the world in which susceptible adult populations exist.
BACKGROUND & AIMS:Hepatitis A virus (HAV) infection is the most common cause of acute hepatitis but is rarely reported during pregnancy. Our aim was to evaluate the impact of acute HAV infection on pregnancy outcome. METHODS: Consecutive admissions of 79,458 pregnant females during a 25-year period were retrospectively reviewed. RESULTS: Thirteen cases of second and third trimester HAV infection were found and evaluated. Nine of the 13 patients (69%) developed gestational complications, including premature contractions (n = 4), placental separation (n = 2), premature rupture of membranes (n = 2), and vaginal bleeding (n = 1). In 8 of these patients, complications led to preterm labor, at a median of 34 gestational weeks (range, 31-37 weeks). Delivery was vaginal in 12 of the 13 cases; fetal distress was noted in a single case, and meconium in amniotic fluid in 2 cases. Median birth weight was 1778 grams and 3040 grams in preterm and term deliveries, respectively (P < .05). Child outcome was favorable in all cases. In 4 cases, neonatal serum HAV RNA levels were measured and found negative. The presence of fever and hypoalbuminemia were associated with delivery at an earlier gestational week. There was a positive relation between gestational week at diagnosis of HAV infection and birth week (r = 0.68, P = .02), suggesting a causality relationship. All mothers featured full recovery from HAV infection. CONCLUSIONS:Acute HAV infection during pregnancy is associated with high risk of maternal complications and preterm labor. HAV serology and maternal vaccination during prepregnancy evaluation should be considered in areas of the world in which susceptible adult populations exist.
Authors: Alexandra Tejada-Strop; Rania A Tohme; Jocelyne Andre-Alboth; Lana Childs; Xin Ji; Vivianne de Oliveira Landgraf de Castro; Jacques Boncy; Saleem Kamili Journal: Am J Trop Med Hyg Date: 2019-07 Impact factor: 2.345
Authors: Ana Martínez; Sonia Broner; M Rosa Sala; Sandra Manzanares-Laya; Pere Godoy; Caritat Planas; Sofia Minguell; Nuria Torner; Mireia Jané; Angela Domínguez; The Working Group For The Study Of The Immune Status In Health Care; For The Study Of Hepatitis A In Catalonia Journal: Hum Vaccin Immunother Date: 2014-11-01 Impact factor: 3.452
Authors: Holly C Groom; Ning Smith; Stephanie A Irving; Padma Koppolu; Gabriela Vazquez-Benitez; Elyse O Kharbanda; Matthew F Daley; James G Donahue; Darios Getahun; Lisa A Jackson; Nicola P Klein; Natalie L McCarthy; James D Nordin; Lakshmi Panagiotakopoulos; Allison L Naleway Journal: Vaccine Date: 2019-09-20 Impact factor: 3.641