Maternal and Perinatal Outcomes among Women Infected with Hepatitis C

Abstract

Background: Hepatitis C virus (HCV) infection remains a major public health concern globally, particularly in low-resource settings. Pregnant women with HCV are at increased risk for adverse maternal and neonatal outcomes, yet research remains limited in this area, especially in regions with high prevalence like Pakistan. Socioeconomic disparity limited antenatal care access, and a lack of public awareness contributes to the continued transmission and complications of HCV during pregnancy. Objective: This study aimed to assess maternal and perinatal outcomes among women infected with hepatitis C, focusing on identifying sociodemographic and clinical factors contributing to disease prevalence and evaluating the impact on maternal health, fetal development, and neonatal wellbeing. Methodology: A descriptive cross-sectional study was conducted over six months, from May 3, 2024, to November 2, 2024, at the Department of Obstetrics and Gynecology, Peoples University of Medical and Health Sciences for Women (PUMHS), Nawabshah. A total of 124 HCV-positive pregnant women aged 15–40 years with singleton pregnancies and gestational age ≥24 weeks were enrolled. Data was collected through structured interviews and medical records, capturing sociodemographic, obstetric, and clinical variables. Outcomes included maternal complications such as preeclampsia, hemorrhage, liver dysfunction, and mode of delivery, as well as neonatal outcomes including preterm birth, low birth weight, stillbirth, early neonatal death, and NICU admission. Data were analyzed using SPSS version 20; chi-square and t-tests determined significance at p < 0.05. Results: Findings revealed that 54.84% of women were unbooked at the time of hospital presentation, and 51.61% belonged to lower socioeconomic backgrounds. Most women presented in serious (30.65%) and critical (27.42%) conditions. Maternal complications were frequent: preeclampsia (17.7%), postpartum hemorrhage (16.9%), liver dysfunction (17.2%), and preterm labor (15.7%). Cesarean and operative deliveries were performed in 63% of cases. Neonatal complications included low birth weight in over 12.4%, preterm birth (19.21%), stillbirths (15.3%), early neonatal deaths (18.6%), and NICU admissions (15.8%). Liver dysfunction and anemia were significantly associated with adverse neonatal outcomes. Critical maternal conditions and preeclampsia were linked to higher stillbirth and ENND rates. Conclusion: This study highlights the severe maternal and perinatal consequences of HCV in pregnancy, particularly among unbooked, low-income women. Findings stress the need for integrated antenatal screening programs, public health education, and targeted interventions to reduce HCV-related complications. Policymakers should prioritize routine HCV testing in pregnancy, improve antenatal care coverage, and invest in research exploring safe antiviral therapies during gestation. Future longitudinal studies are essential to evaluate long-term maternal and neonatal outcomes and establish effective prevention and management strategies in high-burden regions.