Viral Hepatitis in Pregnant Mexican Women: Its Impact in Mother–Child Binomial Health and the Strategies for Its Eradication
Abstract
:1. Introduction
2. Patients and Methods
2.1. Patients
2.2. Variables Extracted from Medical Records
2.3. Statistical Analysis
3. Results
4. Discussion
4.1. HAV in Pregnancy
4.2. HBV and HDV in Pregnancy
4.3. HCV in Pregnancy
4.4. HEV in Pregnancy
4.5. Placental Alterations in Viral Hepatitis
4.6. Mexican Strategies to Eliminate Viral Hepatitis and Their Impact on Pregnant Women and Their Children
5. Concluding Remarks
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic/Type HV | HAV | HBV | HCV | Total |
---|---|---|---|---|
Number | 11 (28.9%) | 11 (28.9%) | 16 (42.1%) | 38 |
Maternal age | 24.91 (26) | 24.45 (24) | 34.31 (35) | 29 ± 6.7 |
Advanced maternal age ≥ 35 years | 0 | 3 (27.3%) | 9 (56.25%) | 12 (31.6%) |
Parity | ||||
First | 2 (18.2%) | 5 (45.5%) | 5 (31.3%) | 12 (31.6%) |
Second | 5 (45.5%) | 2 (18.2%) | 6 (37.5%) | 13 (34.2%) |
Third or more | 4 (36.4%) | 4 (36.4%) | 5 (31.3%) | 11 (29%) |
Previous miscarriages | 1 (9.1%) | 2 (18.2%) | 8 (50%) | 13 (34.2%) |
1 | 0 | 2 (18.2%) | 6 (37.5%) | 8(21.1%) |
≥2 | 1 (9.1%) | 0 | 2 (12.5%) | 3 (7.9%) |
Hepatitis diagnosed | ||||
Before pregnancy | 0 | 1 (9.1%) | 5 (31.3%) | 6 (15.8%) |
By serological screening | 11 (100%) | 9 (81.8%) | 11 (68.8%) | 31 (81.6%) |
By liver biopsy | 0 | 1 (9.1%) | 0 | 1 (2.6%) |
Weeks of gestation at diagnosis | 25 ± 8.03 | 20.36 ± 8.74 | 21.5 ± 12.64 | 23 ± 8.6 |
Asymptomatic patients | 0 | 10 (90.9%) | 13 (81.3%) | 23 (60.5%) |
Symptomatic patients | 11 (100%) | 1 (9.1%) | 3 (18.7%) | 15 (39.5%) |
Jaundice | 9 (81.8%) | 1 (9.1%) | 1 (6.2%) | 11 |
Edema | 2 (18.2%) | 1 (9.1%) | 3 (18.7%) | 6 |
Abdominal pain | 4 (36.4%) | 0 | 0 | 4 |
Choluria/acholia | 6 (54.5%) | 0 | 0 | 6 |
Vomit/nausea | 5 (45.5%) | 0 | 0 | 5 |
Fever | 3 (27.3%) | 0 | 0 | 3 |
Laboratory parameters | ||||
AST > 3 0 μ/L | 3 (27.3%) | 2 (18.2%) | 3 (18.7%) | 8 |
>300 μ/L | 4 (36.4%) | 0 | 0 | 4 |
ALT > 30 μ/L | 1 (9.1%) | 4 (36.4%) | 4 (25%) | 9 |
>300 μ/L | 6 (54.5%) | 0 | 0 | 6 |
LDH > 400 μ/L | 2 (18.2%) | 1 (9.1%) | 4 (25%) | 7 |
TBIL > 2 mg/dL | 7 (63.6%) | 2 (18.2%) | 0 | 9 |
DBIL > 0.5 mg/dL | 7 (63.6%) | 3 (27.3%) | 2 (12.5%) | 12 |
DBIL | 9.2 ± 23.24 | 0.53 ± 0.24 | 0.33 ± 0.29 | p < 0.05 |
Characteristic/Virus Type | HAV | HBV | HCV | Total |
---|---|---|---|---|
Number | 11 (28.9%) | 11 (28.9%) | 16 (42.1%) | 38 |
Comorbidities | ||||
Obesity | 1 (9.1%) | 1 (9.1%) | 3 (18.8%) | 5 (13.2%) |
Systemic hypertension | 1 (9.1%) | 0 | 1 (6.25%) | 2 (5.3%) |
Hypothyroidism | 0 | 1 (9.1%) | 1 (6.25%) | 2 (5.3%) |
Cholelithiasis | 0 | 1 (9.1%) | 1 (6.25%) | 2 |
Toxicomania | 0 | 1 (9.1%) | 1 (6.25%) | 2 |
DM2 | 0 | 0 | 1 (6.25%) | 1 (2.6%) |
HIV | 0 | 1 (9.1%) | 0 | 1 (2.6%) |
Pregnancy related | ||||
ICP | 3 (27.3%) | 0 | 2 (12.5%) | 5 (13.2%) |
Preeclampsia | 0 | 4 (36.4%) | 1 (6.25%) | 5 (13.2%) |
Without comorbidities | 2 (18.2%) | 3 (27.3%) | 3 (18.8%) | 8 (21.1%) |
Complications | ||||
Gestational diabetes | 2 (18.2%) | 5 (45.5%) | 2 (12.5%) | 9 (23.7%) |
Thrombocytopenia | 1 (9.1%) | 0 | 5 (31.3%) | 6 (15.8% |
Anemia | 0 | 1 (9.1%) | 1 (6.25%) | 2 (5.3%) |
Glomerulopathy | 0 | 1 (9.1%) | 0 | 1 (2.6%) |
PRM | 2 (18.2%) | 0 | 1 (6.25%) | 3 (7.9%) |
Postpartum hemorrhage | 3 (27.3%) | 1 (9.1%) | 3 (18.8%) | 7 (18.4) |
Without maternal complications | 4 (36.4%) | 5 (45.5%) | 5 (31.3%) | 14 (36.8%) |
Characteristic/Virus Type | HAV | HBV | HCV | Total |
---|---|---|---|---|
Number | 11 | 11 | 16 | 38 |
Pregnancy outcomes | ||||
Pregnancy length (weeks) | 36.6 (31–39) | 36.7 (27–40) | 37.2 (29–40.3) | 36 ± 4.4 |
Singleton | 10 | 10 | 16 | 36/38 (94.7%) |
Twin | 1 | 1 | 0 | 2/38 (5.3%) |
Term births (≥37 weeks) | 5 | 8 | 11 | 24/35 (63.2%) |
Preterm births (<37 weeks) | 4 | 3 | 4 | 11/35 (28.9%) |
Unspecified pregnancy length | 2 | 0 | 0 | 2/38 (5.2%) |
Miscarriage | 0 | 0 | 1 | 1/38 (2.6%) |
Vaginal delivery | 3 | 3 | 3 | 9/36 (23.7) |
Cesarean section | 7 | 8 | 12 | 27/36 (74.7%) |
Not specified | 1 | 0 | 0 | 1 |
Neonatal outcomes/Number | 12 | 12 | 15 | 39 babies |
Preterm babies (<37 weeks) | 5/10 (50%) | 4 (33.3%) | 4 (26.7%) | 14/37 (37.83%) |
Premature babies (≤33 weeks) | 1/10 (10%) | 1 (8.3%) | 2 (14.3%) | 4/37 (10.8%) |
Small for gestational age | 4/12 (33.33%) | 3 (25%) | 1 (6.7%) | 8/39 (20.5%) |
Large for gestational age | 0 | 0 | 2 (13.3%) | 2/39 (5.1%) |
Jaundice | 8/9 (88.9%) | 6/10 (60%) | 8/12 (66.7%) | 22/32 (68.8%) |
Without jaundice | 1 | 4 | 4 | 9/32 (28.1%) |
Nondeterminate | 2 | 2 | 3 | 7/39 |
NICU admission | 1 | 0 | 1 | 2/39 (5.1%) |
Transition unit care | 0 | 3 | 5 | 8/39 (20.5%) |
Placental Characteristic/Hepatitis Type | HAV | HBV | HCV | Total |
---|---|---|---|---|
Number | 11 | 10 | 14 | 35 |
Normal | 0 | 0 | 1 (7.1%) | 1 (2.9%) |
Hypertrophy | 1 (9.1%) | 0 | 4 (28.6%) | 5 (14.3%) |
Histopathology | ||||
Maternal Vascular Malperfusion | 3 (27.3%) | 3 (30%) | 1 (7.1%) | 7 (20%) |
Hypotrophy | 2 (18.2%) | 3 (30%) | 2 (14.3%) | 7 (20%) |
Infarcts | 2 (18.2%) | 1 (10%) | 0 | 3 (8.6%) |
Retroplacental hemorrhage | 5 (45.5%) | 1 (10%) | 1 (7.1%) | 7 (20%) |
AVM without ISK | 4 (36.4%) | 0 | 0 | 4 (11.4%) |
AVM + ISK | 0 | 1 (10%) | 1 (7.1%) | 2 (5.7%) |
ISK without AVM | 3 (27.3%) | 2 (20%) | 1 (7.1%) | 6 (17.1%) |
Fetal Vascular Malperfusion | 1 (7.1%) | |||
Intervillous fibrinoid | 6 (54.5%) | 3 (30%) | 2 (14.3%) | 11 (31.4%) |
Decidual arteriopathy | 0 | 0 | 3 | 3 (8.6%) |
Stem vessel obliteration | 6 (54.5%) | 1 (10%) | 2 (14.3%) | 9 (25.7%) |
MVM and FVM | 1 (7.1%) | 1 (2.9%) | ||
Delayed Villous Maturation | 4 (36.4%) | 3 (30%) | 5 (35.7%) | 12 (34.3%) |
Acute Intrauterine Infection | ||||
Chorioamnionitis | 1 (9.1%) | 1 (10%) | 1 (7.1%) | 3 (8.6%) |
Microcalcifications | 2 (18.2%) | 2 (20%) | 3 (21.4%) | 7 (20%) |
Chorangiosis | 5 (45.5%) | 3 (30%) | 7 (50%) | 15 (42.9%) |
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García-Romero, C.S.; Guzmán, C.; Martínez-Ibarra, A.; Cervantes, A.; Cerbón, M. Viral Hepatitis in Pregnant Mexican Women: Its Impact in Mother–Child Binomial Health and the Strategies for Its Eradication. Pathogens 2024, 13, 651. https://doi.org/10.3390/pathogens13080651
García-Romero CS, Guzmán C, Martínez-Ibarra A, Cervantes A, Cerbón M. Viral Hepatitis in Pregnant Mexican Women: Its Impact in Mother–Child Binomial Health and the Strategies for Its Eradication. Pathogens. 2024; 13(8):651. https://doi.org/10.3390/pathogens13080651
Chicago/Turabian StyleGarcía-Romero, Carmen Selene, Carolina Guzmán, Alejandra Martínez-Ibarra, Alicia Cervantes, and Marco Cerbón. 2024. "Viral Hepatitis in Pregnant Mexican Women: Its Impact in Mother–Child Binomial Health and the Strategies for Its Eradication" Pathogens 13, no. 8: 651. https://doi.org/10.3390/pathogens13080651