Sharda Patra, MS; Ashish Kumar, MD, DM; Shubha Sagar Trivedi, MS; Manju Puri, MS; Shiv Kumar Sarin, MD, DM
Note: This research was presented in the Plenary Award Session of the 14th Annual Conference of Asia-Pacific Association for the Study of Liver, Bali, Indonesia, 15–22 August 2005.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Shiv Kumar Sarin, MD, DM, Department of Gastroenterology, G.B. Pant Hospital, Room 201, Academic Block, New Delhi 110 002, India; e-mail, firstname.lastname@example.org.
Current Author Addresses: Ms. Patra, Ms. Trivedi, and Ms. Puri: Lady Hardinge Medical College, New Delhi 110 001, India.
Dr. Kumar: Department of Gastroenterology, G.B. Pant Hospital, New Delhi 110 002, India.
Dr. Sarin: Department of Gastroenterology, G.B. Pant Hospital, Room 201, Academic Block, New Delhi 110 002, India.
Author Contributions: Conception and design: S. Patra, A. Kumar, S.S. Trivedi, M. Puri, S.K. Sarin.
Analysis and interpretation of the data: S. Patra, A. Kumar, M. Puri, S.K. Sarin.
Drafting of the article: S. Patra, A. Kumar, M. Puri, S.K. Sarin.
Critical revision of the article for important intellectual content: S. Patra, A. Kumar, S.S. Trivedi, S.K. Sarin.
Final approval of the article: S. Patra, A. Kumar, S.K. Sarin.
Provision of study materials or patients: S. Patra, A. Kumar, S.S. Trivedi, M. Puri, S.K. Sarin.
Administrative, technical or logistic support: A Kumar, S.S. Trivedi, M. Puri, S.K. Sarin.
Collection and assembly of data: S. Patra, A. Kumar, S.K. Sarin.
Hepatitis E virus (HEV) infection is known to cause severe liver disease in pregnant women. It is unclear whether obstetric and fetal outcomes are worse in pregnant women with HEV infection than in women with other forms of viral hepatitis.
To compare maternal, obstetric, and fetal outcomes in pregnant women with acute viral hepatitis caused by HEV and other hepatitis viruses.
Tertiary care hospital, New Delhi, India.
220 consecutive pregnant women presenting with jaundice caused by acute viral hepatitis.
Maternal mortality and medical complications, obstetric complications, deliveries, and fetal outcomes.
Infection with HEV caused acute viral hepatitis in 60% of included women. Fulminant hepatic failure was more common (relative risk, 2.7 [95% CI, 1.7 to 4.2]; P = 0.001) and maternal mortality was greater (relative risk, 6.0 [CI, 2.7 to 13.3]; P < 0.001) in HEV-infected women than in non–HEV-infected women. Women with HEV infection were more likely than those with other forms of viral hepatitis to have obstetric complications (relative risk, 4.1 [CI, 1.7 to 10.2] for antepartum hemorrhage and 1.9 [CI, 1.3 to 2.7] for intrauterine fetal death; P < 0.001 for both) and poor fetal outcomes (relative risk, 1.2 [CI, 1.0 to 1.4] for preterm delivery [P = 0.005] and 1.8 [CI, 1.2 to 2.5] for stillbirth [P = 0.026]).
The findings may not apply to community settings, to women who are asymptomatic or have only minor symptoms, or in the setting of an HEV epidemic.
Pregnant women with jaundice and acute viral hepatitis caused by HEV infection had a higher maternal mortality rate and worse obstetric and fetal outcomes than did pregnant women with jaundice and acute viral hepatitis caused by other types of viral hepatitis.
Sharda Patra, Ashish Kumar, Shubha Sagar Trivedi, Manju Puri, Shiv Kumar Sarin. Maternal and Fetal Outcomes in Pregnant Women with Acute Hepatitis E Virus Infection. Ann Intern Med. 2007;147:28–33. doi: 10.7326/0003-4819-147-1-200707030-00005
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Published: Ann Intern Med. 2007;147(1):28-33.
Gastroenterology/Hepatology, Infectious Disease, Viral Hepatitis.
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