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Maternal hepatitis B or C status and the long‐term risk of gastrointestinal morbidity for offspring: A population‐based cohort study
Author(s) -
Yoles Israel,
Sheiner Eyal,
AbuFreha Naim,
Wainstock Tamar
Publication year - 2019
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.14193
Subject(s) - medicine , offspring , proportional hazards model , population , cumulative incidence , cohort , pediatrics , pregnancy , cohort study , gestational age , survival analysis , gestation , obstetrics , environmental health , genetics , biology
Background More than 360 million people have chronic hepatitis B or C (HBV/HCV) infection worldwide, many of which are women at childbearing age. While the risk of perinatal HBV/HCV has been well established, the long‐term implications on offspring health, have been less studied. We aimed to evaluate the association between maternal HBV/HCV carrier status and long‐term gastrointestinal (GI) morbidities in offspring. Aims & Methods A population‐based cohort analysis compared the risk for long‐term childhood GI morbidities in children born to HBV/HCV carrier mothers vs the risk in those who were born to noncarriers. Childhood GI morbidities were predefined based on ICD‐9 codes, as recorded in hospital medical files. Children with congenital malformations and multiple gestations were excluded from the analysis. A Kaplan‐Meier survival curve was constructed to compare the cumulative GI morbidities over time, and a Cox proportional hazards model was used to control for confounders. Results During the study period (1991‐2014), 242 342 newborns met the inclusion criteria: 771 (0.3%) were born to HBV/HCV mothers and 241 571 (99.7%) were not. The median follow‐up was 10.51 years (0‐18 years). Offspring to HBV/HCV mothers had a higher incidence of GI diseases (9.3% vs 5.4%, OR = 1.82; 95% CI 1.43‐2.32; Kaplan‐Meier log‐rank = 0.001). The increased risk remained significant in the Cox proportional hazards models, which adjusted for gestational age, mode of delivery and pregnancy complications (adjusted HR = 2.26, 95% CI: 1.79‐2.85; P < .001). Conclusion Maternal HBV or HCV carrier status is an independent risk factor for long‐term the GI morbidity of offspring.