Effect of cesarean section on the risk of perinatal transmission of hepatitis C virus from HCV-RNA+/HIV- mothers: a meta-analysis.
Arch Gynecol Obstet. 2010 Jul 21. Epub 2010 Jul 21. PMID: 20652289
Research Center for Gastroenterology and Liver Disease, Ground floor of Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Mollasadra Ave., Vanak Sq., P.O. Box 14155-3651, Tehran, Iran.
BACKGROUND: Hepatitis C virus (HCV) vertical transmission is considered the main route of HCV infection in children. Some authors have stated that cesarean section (C/S) can reduce perinatal HCV transmission. However, the study findings are heterogeneous and high-quality studies are lacking. AIMS: To evaluate the effect of mode of delivery on the risk of perinatal mother-to-infant transmission of HCV. METHODS: Only the peer-reviewed published studies that compared perinatal transmission rate of HCV in elective or emergency cesarean section with vaginal delivery in HCV-RNA+/HIV- mothers were included. We applied the random effect model of DerSimonian and Laird method with heterogeneity and sensitivity analyses. RESULTS: We identified 8 studies that involved 641 unique mother-infant pairs which fulfilled our inclusion criteria. Aggregation of study results did not show a significant decrease in HCV vertical transmission among study (mothers who underwent C/S) versus control (mothers who gave birth vaginally) patients [pooled odds ratio, 1.1 (95% CI 0.45-2.67)]. The P value was 0.35 for our test of heterogeneity. CONCLUSIONS: Our meta-analysis suggests that C/S does not decrease perinatal HCV transmission from HCV-RNA+/HIV- mothers to infants.