Active Screening Strategies and Education for Hepatitis C Infected Pregnant Women are Needed to Improve the Identification of Hepatitis C Exposed Newborns
Methods: The project was conducted in 2 phases. Intervention 1: An educational handout regarding testing of newborns exposed to HCV was developed and given to HCV positive mothers after delivery along with an appointment for testing the newborn. HCV testing and newborn follow-up data were analyzed pre-intervention (Jan-Dec 2012) and post-intervention (Jan-Dec 2013). Intervention 2: To further improve identification of HCV exposed newborns, collaborative measures between Obstetrics (OB) and Pediatric Infectious Disease programs, were implemented. A HCV risk screening questionnaire based on ACOG recommendations was administered to all pregnant women attending a university OB clinic. Women identifying risk factors were tested for HCV antibody. Results from pre-intervention (Jan-Mar 2013) and post-intervention (Jan-Mar 2014) periods were compared.
Results: Prior to intervention 1, 3 (23%) of 13 newborns were tested and all were negative. After intervention 1, 14 (50%) of 28 newborns were tested, 1 was HCV PCR positive. Prior to intervention 2, only 8 (0.7%) of 1112 pregnant women were tested for HCV and all were negative, compared to 116 (12%) of 977 women after intervention 2 (p<.0001, chi-square test). 7 (6%) were HCV antibody positive.
Conclusion: Our data suggest that educational handouts improve HCV testing of exposed newborns. In addition, many HCV infected pregnant women and their exposed newborns would not be identified unless active interventions for screening are in place. Universal testing of pregnant women may be a better strategy to identify HCV exposed newborns.
K. Best, None
T. Walker, None