Historical Analysis of the Risk of Hepatitis E and Its Complications in Pregnant Women in Nepal, 1996

Historical Analysis of the Risk of Hepatitis E and Its Complications in Pregnant Women in Nepal, 1996–1998

Published:2021-08-11 Issue:2 Volume:105 Page:440-448
ISSN:0002-9637
Container-title:The American Journal of Tropical Medicine and Hygiene
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Author:

Scott Robert McNair¹,Kmush Brittany L.²,Norkye Kundu¹³,Hada Meera³,Shrestha Mrigendra Prasad¹,Vaughn David W.⁴⁵,Myint Khin Saw Aye⁴,Endy Timothy P.⁴,Shrestha Sanjaya K.¹,Innis Bruce L.⁶⁷

Affiliation:

1. 1Walter Reed/AFRIMS Research Unit—Nepal, Kathmandu, Nepal;

2. 2Department of Public Health, Food Studies, and Nutrition, Syracuse University, Syracuse, New York;

3. 3Patan Hospital, Kathmandu, Nepal;

4. 4Department of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand;

5. 5Integrated Clinical Vaccine Development, Bill & Melinda Gates Foundation, Seattle, Washington;

6. 6Department of Virus Diseases, Walter Reed Army Institute of Research, Silver Spring, Maryland;

7. 7Global Vaccine Development, GlaxoSmithKline Biologicals, King of Prussia, Pennsylvania

Abstract

ABSTRACT. Hepatitis E (HE) during pregnancy can be fatal; there are no prospective risk estimates for HE and its complications during pregnancy. We followed 2,404 pregnant women for HE and pregnancy outcomes from 1996 to 1998. Subjects from Nepal were enrolled at an antenatal clinic with pregnancy of ≤ 24 weeks. Most women (65.1%) were anti-HE virus negative. There were 16 cases of HE (6.7 per 1,000); three mothers died (18.8%) having had intrauterine fetal death (IUFD). Thirteen mothers survived: five preterm and seven full-term deliveries, one IUFD. HE among seronegative women was the sole cause of maternal death and increased the risk of IUFD (relative risk [RR]: 10.6; 95% confidence interval [CI]: 4.29–26.3) and preterm delivery (RR: 17.1, 95% CI 7.56–38.5). HE vaccination of females in at-risk regions before or as they attain reproductive age would reduce their risk for preterm delivery, IUFD, and maternal death.

Publisher

American Society of Tropical Medicine and Hygiene

Subject

Virology,Infectious Diseases,Parasitology

Link

https://www.ajtmh.org/downloadpdf/journals/tpmd/105/2/article-p440.xml

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