Publication:

Sero-prevalence of hepatitis B virus and risk analysis of vertical transmission among pregnant women attending the obstetrics and gynecology hospital, Chennai (Tamilnadu), India

Background Majority of the transmission of Hepatitis B viral infection occurs by vertical transmission from a carrier mother to infants. However, data regarding the seroprevalence of hepatitis B virus infection in pregnant women and risk factors associated with vertical transmission are lacking in India especially South India.

Methods A cross-sectional, prospective study was conducted at Institute of Obstetric and Gynecology and Department of Hepatology, Madras Medical College, Chennai, Tamil Nadu, India. The study included of 2730 consecutive pregnant women and 160 cord blood samples of neonates of HBsAg positive mothers.

Results The seroprevalence of HBsAg was found to be 5.86% among pregnant women. Vertical transmission was documented in 27.5% (44 of 160) of neonates born to mothers who were positive for HBsAg, it was highest in India reported anywhere. Although univariate analysis had shown the association of vertical transmission of HBV infection with maternal factors such as HBeAg, HBV DNA, Infection status, anti-HBe and mode of delivery, Multivariate analysis had revealed that LSCS is independent risk factor (OR, 0.057; 95% CI, 0.010 - 0.312; P<0.001)  for vertical transmission.

Conclusions Prevalence of HBV in pregnant women was found to be high compared to general population reported earlier. LSCS had independent risk factor on vertical transmission than any other risk factors. Therefore, LSCS may not be advisable in HBsAg-positive pregnant women to prevent vertical transmission of HBV.